Hussain Manik Zuhudha, George John, Sockalingam Sargunan
University of Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Scientifica (Cairo). 2016;2016:5609132. doi: 10.1155/2016/5609132. Epub 2016 Apr 13.
Objective. To compare ultrasound synovial thickness of the 2nd, 3rd and 4th metacarpophalangeal joints (MCPJ) in a group of patients with proven rheumatoid arthritis (RA) and a control group of normal individuals. Materials and Methods. This is a cross-sectional study comprising 30 rheumatoid arthritis patients and 30 healthy individuals. Ultrasound scans were performed at the dorsal side of 2nd, 3rd, and 4th MCPJ of both hands in RA patients and the healthy individuals. Synovial thickness was measured according to quantitative method. The synovial thickness of RA patients and healthy individuals was compared and statistical cut-off was identified. Results. Maximum synovial thickness was most often detected at the radial side of the 2nd MCPJ and 3rd MCPJ and ulnar side of the 4th MCPJ of both hands which is significantly higher (p < 0.05) in RA patients compared to healthy individuals. With high specificity (96%) and sensitivity (90%) the optimum cut-off value to distinguish RA patients and healthy individuals' synovial thickness differs for the radial side of the 2nd and 3rd MCPJ and ulnar side of the 4th MCPJ. Conclusion. Patients with early RA appear to exhibit a characteristic pattern of synovitis which shows radial side predominance in the 2nd and 3rd MCPJ and ulnar side in the 4th MCPJ.
目的。比较一组确诊为类风湿关节炎（RA）的患者与正常个体对照组中第二、三、四掌指关节（MCPJ）的超声滑膜厚度。材料与方法。这是一项横断面研究，包括30例类风湿关节炎患者和30名健康个体。对RA患者和健康个体的双手第二、三、四MCPJ背侧进行超声扫描。根据定量方法测量滑膜厚度。比较RA患者和健康个体的滑膜厚度，并确定统计学临界值。结果。最大滑膜厚度最常出现在双手第二MCPJ和第三MCPJ的桡侧以及第四MCPJ的尺侧，与健康个体相比，RA患者的该厚度显著更高（p < 0.05）。区分RA患者和健康个体滑膜厚度的最佳临界值在第二和第三MCPJ的桡侧以及第四MCPJ的尺侧具有高特异性（96%）和敏感性（90%）。结论。早期RA患者似乎表现出一种特征性的滑膜炎模式，在第二和第三MCPJ中表现为桡侧为主，在第四MCPJ中表现为尺侧为主。
