Najm Aurélie, Orr Carl, Gallagher Lorna, Biniecka Monika, Gaigneux Emeline, Le Goff Benoit, Fearon Ursula, Veale Douglas J
Rheumatology Department, Centre Hospitalier Universitaire de Nantes, Nantes, Pays de la Loire, France.
The Centre for Arthritis and Rheumatic Diseases, Saint Vincent's University Hospital and Dublin Academic Medical Centre, University College Dublin, Dublin, Ireland.
RMD Open. 2018 Feb 8;4(1):e000616. doi: 10.1136/rmdopen-2017-000616. eCollection 2018.
Ultrasonography (US) is a fast, available and low-cost imaging tool used for detecting knee synovitis. Our aims were to assess the relationship between US and histology findings in appraising levels of inflammation and vascularity in the knee joint in subjects with inflammatory arthropathies; to determine whether differences exist in the appraisal between varying knee compartments and to compare US performances compared with gold standard histology for knee synovitis detection.
Subjects with actively inflamed knee joint having crystal arthropathies, rheumatoid arthritis, psoriatic arthritis or ostoearthritis were prospectively recruited from rheumatology clinics after giving their written consent between May and October 2015. Study was approved by the institutional ethics committee. The knee was divided into three compartments (medial, lateral, superior). Patients had a knee US followed by a knee arthroscopy with biopsies retrieval from each compartment. Biopsies were blindly scored for lining layer hyperplasia, inflammation, vascularity, CD68 and factor VIII staining. Correlation was determined using the Spearman's correlation test.
26 patients with active arthritis in a knee joint and recent onset of disease were prospectively included. Strong correlations were observed between US synovitis grade and histological inflammation score (r=0.63; P=0.002), US Doppler grade and histological score for vascularity (r=0.68; P<0.001); US measured synovial thickness and lining layer hyperplasia (r=0.61; P=0.002). Moderate correlation was found between US synovitis grade and CD68 score (r=0.49; P=0.02).
US findings correlate with histological inflammation and vascularity scores in actively inflamed knee joints. US accurately describes knee synovitis.
超声检查（US）是一种用于检测膝关节滑膜炎的快速、便捷且低成本的成像工具。我们的目的是评估在评估炎性关节病患者膝关节炎症和血管化水平时，超声检查结果与组织学检查结果之间的关系；确定不同膝关节腔室在评估方面是否存在差异，并将超声检查在检测膝关节滑膜炎方面的表现与金标准组织学检查进行比较。
2015年5月至10月期间，在获得书面同意后，从风湿病诊所前瞻性招募患有晶体性关节病、类风湿关节炎、银屑病关节炎或骨关节炎且膝关节有活动性炎症的患者。该研究得到了机构伦理委员会的批准。膝关节被分为三个腔室（内侧、外侧、上方）。患者先进行膝关节超声检查，然后进行膝关节镜检查，并从每个腔室取活检组织。对活检组织进行盲法评分，评估衬里层增生、炎症、血管化、CD68和因子VIII染色情况。使用Spearman相关检验确定相关性。
前瞻性纳入了26例膝关节有活动性关节炎且疾病近期发作的患者。观察到超声滑膜炎分级与组织学炎症评分之间存在强相关性（r = 0.63；P = 0.002），超声多普勒分级与组织学血管化评分之间存在强相关性（r = 0.68；P < 0.001）；超声测量的滑膜厚度与衬里层增生之间存在强相关性（r = 0.61；P = 0.002）。超声滑膜炎分级与CD68评分之间存在中度相关性（r = 0.49；P = 0.02）。
超声检查结果与活动性炎症膝关节的组织学炎症和血管化评分相关。超声能准确描述膝关节滑膜炎。
