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一种最近开发的用于手部骨关节炎的MRI评分系统:其在临床环境中的应用。

A recently developed MRI scoring system for hand osteoarthritis: its application in a clinical setting.

作者信息

Ramonda Roberta, Favero Marta, Vio Stefania, Lacognata Carmelo, Frallonardo Paola, Belluzzi Elisa, Campana Carla, Lorenzin Mariagrazia, Ortolan Augusta, Angelini Federico, Piccoli Antonio, Oliviero Francesca, Punzi Leonardo

机构信息

Rheumatology Unit, Department of Medicine DIMED, University of Padova, Padova, Italy.

Laboratory of Immunorheumatology and Tissue Regeneration/RAMSES, Rizzoli Orthopedic Research Institute, Bologna, Italy.

出版信息

Clin Rheumatol. 2016 Aug;35(8):2079-2086. doi: 10.1007/s10067-016-3303-0. Epub 2016 May 28.

Abstract

This study aimed to apply the recently proposed Oslo hand osteoarthritis magnetic resonance imaging (MRI) scoring system to evaluate MRI findings in a cohort of patients affected by long-standing erosive hand osteoarthritis (EHOA). Eleven female EHOA patients (median 59 [interquartile range 62-52] years, disease duration 9.5 [interquartile range 13-3.75] years) underwent MRI (1.5 T) of the dominant hand, and synovitis, bone marrow lesions (BMLs), joint space narrowing, osteophytes, cysts, malalignment, and erosions were scored using the Oslo scoring system. Intra- and inter-reader reliability were assessed. The patients also underwent X-ray examination, and bone features were evaluated using the same scoring system. Pain and tenderness were assessed during a physical examination. Spearman's non-parametric test was used to analyze the correlations between variables. MRI intra- and inter-reader reliability were found between good and moderate for many features. No statistical differences were found between the radiographs and MRI with regard to detection of JSN, malalignment, and bone erosions. Synovitis was detected in 39.8 % of the 80 joints examined (in a mild form in 80 %), erosions were found in 51.1 %, and BMLs were identified in 20.5 and 23.9 % at the distal and the proximal side, respectively. BMLs at both the proximal and distal ends were correlated with tender joints (BML distal p = 0.0013, BML proximal p = 0.012). The presence of synovitis was correlated with tenderness (p = 0.004) and erosions at both the distal and proximal joints (p = 0.004). The presence of erosions correlated with tender joints (p < 0.01) and the mean visual analog scale (VAS) score (distal p = 0.03, proximal p = 0.01). Synovitis and BMLs were correlated with clinical symptoms in our patients affected with long-standing EHOA.

摘要

本研究旨在应用最近提出的奥斯陆手部骨关节炎磁共振成像(MRI)评分系统,评估一组长期患有侵蚀性手部骨关节炎(EHOA)患者的MRI表现。11例女性EHOA患者(年龄中位数59岁[四分位间距62 - 52岁],病程9.5年[四分位间距13 - 3.75年])接受了优势手的MRI(1.5T)检查,并使用奥斯陆评分系统对滑膜炎、骨髓病变(BMLs)、关节间隙变窄、骨赘、囊肿、排列不齐和侵蚀进行评分。评估了阅片者内和阅片者间的可靠性。患者还接受了X线检查,并使用相同的评分系统评估骨骼特征。在体格检查期间评估疼痛和压痛情况。采用Spearman非参数检验分析变量之间的相关性。对于许多特征,MRI阅片者内和阅片者间的可靠性在良好和中等之间。在检测关节间隙变窄、排列不齐和骨侵蚀方面,X线片和MRI之间未发现统计学差异。在所检查的80个关节中,39.8%检测到滑膜炎(80%为轻度),51.1%发现侵蚀,远端和近端分别有20.5%和23.9%发现BMLs。近端和远端的BMLs均与压痛关节相关(远端BML p = 0.0013,近端BML p = 0.012)。滑膜炎的存在与压痛相关(p = 0.004)以及远端和近端关节的侵蚀相关(p = 0.004)。侵蚀的存在与压痛关节相关(p < 0.01)以及平均视觉模拟量表(VAS)评分相关(远端p = 0.03,近端p = 0.01)。在我们患有长期EHOA的患者中,滑膜炎和BMLs与临床症状相关。

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