Fujimura Takanori, Fujimoto Takashi, Hara Ryota, Shimmyo Naoki, Kobata Yasunori, Kido Akira, Akai Yasuhiro, Tanaka Yasuhito
a The Center for Rheumatic Diseases, Nara Medical University , Kashihara, Nara , Japan.
Mod Rheumatol. 2015;25(6):871-5. doi: 10.3109/14397595.2015.1045259. Epub 2015 May 27.
To evaluate the subclinical articular involvement in patients with primary Sjögren's syndrome (pSS) using musculoskeletal ultrasound (MSUS), and to correlate the findings with laboratory results and clinical manifestations.
Forty-eight consecutive patients with pSS were enrolled. The bilateral metacarpophalangeal, proximal interphalangeal, and interphalangeal joints were examined using MSUS, and the synovial hypertrophy and power Doppler signal were recorded for each joint using semi-quantitative scores (0 = normal, 1 = mild change compared with undamaged joint, 2 = moderate change, and 3 = severe change).
Mild or moderate synovial hypertrophy was found in 151 (15.7%) and 2 (0.2%) out of 960 hand joints, respectively, and power Doppler signals were present in 19 (2.0%) of the 960 joints. While anti-centromere antibody (ACA) was found in 10 patients (20.8%), none of the patients with MSUS-confirmed synovitis was positive for ACA. No other autoantibodies, laboratory tests, or clinical manifestations correlated with MSUS-confirmed synovitis.
MSUS is useful for detecting subclinical synovitis in pSS patients. MSUS showed that ACA-positive pSS patients had a low prevalence of synovitis.
使用肌肉骨骼超声（MSUS）评估原发性干燥综合征（pSS）患者的亚临床关节受累情况，并将结果与实验室检查结果及临床表现进行关联。
纳入48例连续的pSS患者。使用MSUS检查双侧掌指关节、近端指间关节和指间关节，使用半定量评分（0 = 正常，1 = 与未受损关节相比轻度改变，2 = 中度改变，3 = 重度改变）记录每个关节的滑膜增生和能量多普勒信号。
960个手部关节中，分别有151个（15.7%）和2个（0.2%）发现轻度或中度滑膜增生，960个关节中有19个（2.0%）存在能量多普勒信号。10例患者（20.8%）检测出抗着丝点抗体（ACA），但MSUS确诊的滑膜炎患者中无ACA阳性者。没有其他自身抗体、实验室检查或临床表现与MSUS确诊的滑膜炎相关。
MSUS有助于检测pSS患者的亚临床滑膜炎。MSUS显示，ACA阳性的pSS患者滑膜炎患病率较低。
