关节炎影像学关节间隙宽度测量与超声评估儿童幼年特发性关节炎软骨厚度的比较。
A Comparison of Radiographic Joint Space Width Measurements Versus Ultrasonographic Assessment of Cartilage Thickness in Children with Juvenile Idiopathic Arthritis.
机构信息
From the Department of Pediatrics, and the Department of Radiology, Aarhus University Hospital, Aarhus, Denmark.
D.Ø. Pradsgaard, MD, PhD, Department of Pediatrics, Aarhus University Hospital; A. Hørlyck, MD, Department of Radiology, Aarhus University Hospital; A.H. Spannow, MD, PhD, Department of Pediatrics, Aarhus University Hospital; C. Heuck, MD, PhD, Department of Pediatrics, Aarhus University Hospital; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University Hospital.
出版信息
J Rheumatol. 2019 Mar;46(3):301-308. doi: 10.3899/jrheum.170571. Epub 2018 Nov 15.
OBJECTIVE
Joint space narrowing (JSN) is a measurable outcome of tissue degeneration in arthritis. JSN is usually assessed by conventional radiography. Ultrasonographic (US) measurement of joint cartilage thickness has been validated in healthy children, and US measurement of the distal femoral cartilage has been validated in a group of patients with juvenile idiopathic arthritis (JIA). Our aim was to compare the measures of cartilage thickness of the proximal cartilage site in the second metacarpophalangeal (MCP), second proximal interphalangeal (PIP), and knee joints as assessed by US to joint space width (JSW) as measured by computerized radiography in children with JIA.
METHODS
The study included 74 children with JIA aged 5-15 years (median 11.3 yrs). MCP and PIP joints were assessed at one midline spot. Knee joints were assessed at the medial and lateral femoral condylar areas. Only the proximal cartilage site in the joints was assessed by US, whereas the complete JSW was assessed by radiography.
RESULTS
We assessed 136 second MCP, 138 second PIP, and 146 knee joints. We found a high level of agreement between US and radiographic measures of cartilage thickness and JSW: r = 0.82-0.86 (second MCP), r = 0.50-0.55 (second PIP), and r = 0.52-0.81 (knee); p < 0.001 for all 8 assessed sites.
CONCLUSION
US measurements of cartilage thickness of the proximal site of the second MCP, second PIP, and knee joints correlated well with radiographic JSW measurements in the finger and knee joints of children with JIA. However, US does not measure the distal cartilage, which may limit its use in the assessment of JSN.
目的
关节间隙变窄（JSN）是关节炎组织退化的可测量结果。JSN 通常通过常规放射照相术进行评估。关节软骨厚度的超声（US）测量已在健康儿童中得到验证，并且在一组幼年特发性关节炎（JIA）患者中已验证了远端股骨软骨的 US 测量。我们的目的是比较超声评估的第二掌指关节（MCP）、第二近端指间关节（PIP）和膝关节近端软骨部位的软骨厚度测量值与计算机放射照相术测量的关节间隙宽度（JSW）在 JIA 患儿中的相关性。
方法
该研究纳入了 74 名 5-15 岁（中位数 11.3 岁）的 JIA 患儿。MCP 和 PIP 关节在一个中线点进行评估。膝关节在股骨内外侧髁区域进行评估。仅通过 US 评估关节的近端软骨部位，而通过放射照相术评估完整的 JSW。
结果
我们评估了 136 个第二 MCP、138 个第二 PIP 和 146 个膝关节。我们发现 US 和放射照相术测量的软骨厚度和 JSW 之间具有高度一致性：r = 0.82-0.86（第二 MCP），r = 0.50-0.55（第二 PIP）和 r = 0.52-0.81（膝关节）；所有 8 个评估部位的 p 值均<0.001。
结论
在 JIA 患儿的手指和膝关节中，US 测量的第二 MCP、第二 PIP 和膝关节近端软骨部位的厚度与放射照相术 JSW 测量值相关性良好。然而，US 并未测量远端软骨，这可能限制了其在 JSN 评估中的应用。
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