类风湿关节炎骨侵蚀超声评估的系统文献综述总结结果
Summary Findings of a Systematic Literature Review of the Ultrasound Assessment of Bone Erosions in Rheumatoid Arthritis.
作者信息
Szkudlarek Marcin, Terslev Lene, Wakefield Richard J, Backhaus Marina, Balint Peter V, Bruyn George A W, Filippucci Emilio, Gandjbakhch Frederique, Iagnocco Annamaria, Mandl Peter, Möller Ingrid, Naredo Esperanza, Schmidt Wolfgang A, d'Agostino Maria Antonietta
机构信息
From the Department of Rheumatology, Copenhagen University Hospital at Køge, Køge; Center for Rheumatology and Spine Diseases, Copenhagen University Hospital at Glostrup, Copenhagen, Denmark; Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM) Section of Musculoskeletal Disease, University of Leeds, Chapel Allerton Hospital, Leeds, UK; Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin, Berlin; Immanuel Krankenhaus Berlin, Medical Centre for Rheumatology, Berlin-Buch, Germany; Third Department of Rheumatology, National Institute of Rheumatology and Physiotherapy, Budapest, Hungary; Department of Rheumatology, MC Groep, Lelystad, the Netherlands; Clinica Reumatologica, Università Politecnica delle Marche, Jesi, Ancona; Rheumatology Unit, Dipartmento Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome, Italy; Rheumatology Department, Université Paris 6-Pierre et Marie Curie, Hôpital La Pitié Salpetrière, Assistance Publique - Hôpitaux de Paris (APHP), Paris; Rheumatology Department, Université Paris Ouest-Versailles-Saint Quentin en Yvelines, Hôpital Ambroise Paré, Boulogne-Billancourt, France; Division of Rheumatology, University of Vienna, Vienna, Austria; Instituto Poal de Reumatologia-Hospital Platon, Barcelona; Department of Rheumatology, Hospital General Universitario Gregorio Marañón and Complutense University, Madrid, Spain.M. Szkudlarek, MD, PhD, Department of Rheumatology, Copenhagen University Hospital at Køge; L. Terslev, MD, PhD, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital at Glostrup; R.J. Wakefield, BM, FRCP, MD, Senior Lecturer and Honorary Consultant Rheumatologist, LIRMM Section of Musculoskeletal Disease, University of Leeds, Chapel Allerton Hospital; M. Backhaus, Professor, Dr. Med., Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin; P.V. Balint, MD, PhD, FRCP, Third Department of Rheumatology, Nationa
出版信息
J Rheumatol. 2016 Jan;43(1):12-21. doi: 10.3899/jrheum.141416. Epub 2015 Dec 1.
OBJECTIVE
Bone erosions in rheumatoid arthritis (RA) have been studied in an increasing amount of research. Both earlier and present classification criteria of RA contain erosions as a significant classification component. Ultrasound (US) can detect bone changes in accessible surfaces. Therefore, the study group performed a systematic literature review of assessment of RA bone erosions with US.
METHODS
A systematic search of PubMed and Embase was performed. Data on the definitions of RA bone erosions, their size, scoring, relation to synovitis, comparators, and elements of the OMERACT (Outcome Measures in Rheumatology Clinical Trials) filter were collected and analyzed.
RESULTS
The selection process identified 58 original research papers. The assessed joints were most frequently metacarpophalangeal (MCP; 41 papers), proximal interphalangeal (19 papers), and metatarsophalangeal joints (MTP; 18 papers). The OMERACT definition of RA bone erosion on US was used most often (17 papers). Second and fifth MCP and fifth MTP were recommended as target joints. Conventional radiography was the most frequently used comparator (27 papers), then magnetic resonance imaging (17 papers) and computed tomography (5 papers). Reliability of assessment was presented in 20 papers and sensitivity to change in 11 papers.
CONCLUSION
This paper presents results of a systematic literature review of bone erosion assessment in RA with US. The survey suggests that US can be a helpful adjunct to the existing methods of imaging bone erosions in RA. It analyzes definitions, scoring systems, used comparators, and elements of the OMERACT filter. It also presents recommendations for a future research agenda based on the results of the review.
目的
类风湿关节炎（RA）中的骨侵蚀已在越来越多的研究中得到探讨。RA的早期和现行分类标准均将侵蚀作为重要的分类组成部分。超声（US）能够检测可触及表面的骨骼变化。因此，该研究团队对采用US评估RA骨侵蚀进行了系统的文献综述。
方法
对PubMed和Embase进行了系统检索。收集并分析了有关RA骨侵蚀的定义、大小、评分、与滑膜炎的关系、对照方法以及风湿病临床试验结果评估（OMERACT）筛选要素的数据。
结果
筛选过程共识别出58篇原创研究论文。评估的关节最常见的是掌指关节（MCP；41篇论文）、近端指间关节（19篇论文）和跖趾关节（MTP；18篇论文）。US上RA骨侵蚀的OMERACT定义使用最为频繁（17篇论文）。推荐将第二和第五掌指关节以及第五跖趾关节作为目标关节。传统X线摄影是最常用的对照方法（27篇论文），其次是磁共振成像（17篇论文）和计算机断层扫描（5篇论文）。20篇论文阐述了评估的可靠性，11篇论文阐述了对变化的敏感性。
结论
本文呈现了采用US评估RA骨侵蚀的系统文献综述结果。该调查表明，US可作为RA现有骨侵蚀成像方法的有益辅助手段。它分析了定义、评分系统、使用的对照方法以及OMERACT筛选要素。还根据综述结果提出了未来研究议程的建议。
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