[附着点炎的超声特征：寻常型银屑病患者与银屑病关节炎患者的比较]

[Ultrasonic Features of Enthesitis: a Comparison Between Patients with Psoriasis Vulgaris and Patients with Psoriatic Arthritis].

作者信息

Tang Yuan-Jiao, Xiang Xi, Yang Yu-Jia, Wang Li-Yun, He Ying, Qiu Li

机构信息

Department of Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, China.

出版信息

Sichuan Da Xue Xue Bao Yi Xue Ban. 2017 Jul;48(4):589-594.

PMID:28752980

Abstract

OBJECTIVE

To compare the ultrasonic features of enthesitis between psoriatic arthritis and psoriasis vulgaris.

METHODS

A total of 39 patients with psoriatic arthritis (PsA group), 60 with psoriasis vulgaris (non-PsA group) and 60 healthy people (control group) participated in this study. They were examined by two-dimensional and color Doppler ultrasound on the entheses of bilateral femoral quadriceps tendons, patella tendons, Achilles tendons, plantar fasciae, common flexor tendons and common extensor tendons.

RESULTS

About 45% (27 cases) healthy controls had enthesitis, with Achilles tendons and femoral quadriceps tendons being most likely affected. No blood flow signal was observed on the affected sites. About 63% (38 cases) of non-PsA patients had enthesitis, with Achilles tendons and femoral quadriceps tendons being most likely affected. Blood flow signals were observed on 4 affected sites. More than 84% (33 cases) PsA patients had enthesitis, with all locations being likely affected but mostly on Achilles tendons, femoral quadriceps tendons, and plantar fasciae. Blood flow signals were observed on 18 affected sites. The differences in prevalence of enthesitis were statistically significant (PsA group>non-PsA group>control group, all <0.01), although the differences in tendon hypoechogenicity and enthesophytes among the groups showed no statistical significance. PsA and non-PsA patients were more likely to have tendon thickening than the controls (both <0.01); but no difference appeared between PsA and non-PsA patients. PsA patients had higher prevalence of intratendinous calcifications, bony erosions and color Doppler signals than non-PsA patients and the controls (all <0.01).

CONCLUSION

Enthesitis in healthy people and non-PsA patients are most likely to affect Achilles tendon and femoral quadriceps tendons. By contrast, Achilles tendons, femoral quadriceps tendon and plantar fascia are more likely to be affected in patients with PsA. PsA patients have high prevalence of enthesitis and are more likely to have intratendinous calcifications, bony erosions and color Doppler signals.

摘要

目的

比较银屑病关节炎与寻常型银屑病患者附着点炎的超声特征。

方法

本研究共纳入39例银屑病关节炎患者（PsA组）、60例寻常型银屑病患者（非PsA组）和60例健康人（对照组）。对双侧股四头肌肌腱、髌腱、跟腱、跖腱膜、屈肌总腱和伸肌总腱的附着点进行二维及彩色多普勒超声检查。

结果

约45%（27例）健康对照者存在附着点炎，其中跟腱和股四头肌肌腱最易受累。受累部位未观察到血流信号。约63%（38例）非PsA患者存在附着点炎，跟腱和股四头肌肌腱最易受累。4个受累部位观察到血流信号。超过84%（33例）PsA患者存在附着点炎，所有部位均可能受累，但主要累及跟腱、股四头肌肌腱和跖腱膜。18个受累部位观察到血流信号。附着点炎患病率差异具有统计学意义（PsA组>非PsA组>对照组，均P<0.01），尽管各组间肌腱低回声和骨赘差异无统计学意义。PsA组和非PsA组患者肌腱增厚的可能性均高于对照组（均P<0.01）；但PsA组和非PsA组患者之间无差异。PsA患者肌腱内钙化、骨质侵蚀和彩色多普勒信号的患病率高于非PsA患者和对照组（均P<0.01）。