痛风石性痛风患者跟腱的超声特征：与年龄和性别匹配的对照者比较。

Ultrasound Characteristics of the Achilles Tendon in Tophaceous Gout: A Comparison with Age- and Sex-matched Controls.

机构信息

From the Health and Rehabilitation Research Institute, Auckland University of Technology; Faculty of Medical and Health Sciences, The University of Auckland; Department of Rheumatology, Auckland District Health Board; Horizon Radiology Ltd., Auckland University of Technology North Shore Campus, Auckland; Department of Medicine, University of Otago, Christchurch, Christchurch, New Zealand.

M. Carroll, PhD, MSc, BHSc, Health and Rehabilitation Research Institute, Auckland University of Technology; N. Dalbeth, MBChB, MD, FRACP, Faculty of Medical and Health Sciences, The University of Auckland, and Department of Rheumatology, Auckland District Health Board; B. Allen, MBChB, FRANZCR, Horizon Radiology Ltd., Auckland University of Technology North Shore Campus; S. Stewart, PhD, BHSc (Hons), Health and Rehabilitation Research Institute, Auckland University of Technology; T. House, MBChB, FRANZCR, Horizon Radiology Ltd., Auckland University of Technology North Shore Campus; M. Boocock, PhD, MSc, BA (Hons), Health and Rehabilitation Research Institute, Auckland University of Technology; C. Frampton, PhD, BSc (Hons), Department of Medicine, University of Otago, Christchurch; K. Rome, PhD, MSc, BSc (Hons), Health and Rehabilitation Research Institute, Auckland University of Technology.

出版信息

J Rheumatol. 2017 Oct;44(10):1487-1492. doi: 10.3899/jrheum.170203. Epub 2017 Aug 1.

DOI:10.3899/jrheum.170203

PMID:28765249

Abstract

OBJECTIVE

To investigate the frequency and distribution of characteristics of the Achilles tendon (AT) in people with tophaceous gout using musculoskeletal ultrasound (US).

METHODS

Twenty-four participants with tophaceous gout and 24 age- and sex-matched controls without gout or other arthritis were recruited. All participants underwent a greyscale and power Doppler US examination. The AT was divided into 3 anatomical zones (insertion, pre-insertional, and proximal to the mid-section). The following US characteristics were assessed: tophus, tendon echogenicity, tendon vascularity, tendon morphology, entheseal characteristics, bursal morphology, and calcaneal bone profile.

RESULTS

The majority of the participants with tophaceous gout were middle-aged men (n = 22, 92%) predominately of European ethnicity (n = 14, 58%). Tophus deposition was observed in 73% (n = 35) of tendons in those with gout and in none of the controls (p < 0.01). Intratendinous hyperechoic spots (p < 0.01) and intratendinous power Doppler signal (p < 0.01) were more frequent in participants with gout compared to controls. High prevalence of entheseal calcifications, calcaneal bone cortex irregularities, and calcaneal enthesophytes were observed in both gout participants and controls, without differences between groups. Intratendinous structural damage was rare. Hyperechoic spots were significantly more common at the insertion compared to the zone proximal to the mid-section (p < 0.01), but between-zone differences were not observed for other features.

CONCLUSION

US features of urate deposition, tophus, and vascularization are present throughout the AT in patients with tophaceous gout. Despite crystal deposition, intratendinous structural changes are infrequent. Many characteristics observed in the AT in people with tophaceous gout, particularly at the calcaneal enthesis, are not disease-specific.

摘要

目的

使用肌肉骨骼超声（US）研究痛风石患者跟腱（AT）的特征的频率和分布。

方法

招募了 24 名痛风石患者和 24 名年龄和性别匹配的无痛风或其他关节炎的对照组参与者。所有参与者均接受灰阶和功率多普勒超声检查。将 AT 分为 3 个解剖区域（插入、插入前和中段近端）。评估以下 US 特征：痛风石、肌腱回声、肌腱血管、肌腱形态、腱末端特征、滑囊形态和跟骨骨轮廓。

结果

大多数痛风石患者为中年男性（n = 22，92%），主要为欧洲血统（n = 14，58%）。痛风患者的肌腱中有 73%（n = 35）出现痛风石沉积，而对照组中没有（p < 0.01）。与对照组相比，痛风患者的肌腱内高回声点（p < 0.01）和肌腱内功率多普勒信号（p < 0.01）更为常见。痛风患者和对照组均存在腱末端钙化、跟骨皮质不规则和跟腱末端病的高患病率，但组间无差异。肌腱内结构损伤罕见。与中段近端相比，插入处的高回声点明显更为常见（p < 0.01），但其他特征在各区域之间无差异。