1 Department of Clinical and Molecular Sciences, Rheumatology Unit, Polytechnic University of Marche, Ancona, Italy.
2 Rheumatology Department, Musgrave Park Hospital, Belfast, UK.
Lupus. 2019 Apr;28(5):583-590. doi: 10.1177/0961203319834671. Epub 2019 Mar 6.
Musculoskeletal manifestations are extremely common in patients with systemic lupus erythematosus. Transient and migratory arthralgia is frequently reported even without clinical signs of joint or tendon inflammation. In less than 15% of patients, joints may be more severely affected by deforming (Jaccoud's arthropathy) and/or erosive arthropathy (Rhupus syndrome). In recent years, ultrasound has emerged as a promising imaging technique for the assessment of musculoskeletal involvement in systemic lupus erythematosus, having demonstrated the ability to detect inflammation and structural damage both at articular and periarticular level. Recent ultrasound studies have also revealed new insights into musculoskeletal involvement in patients with systemic lupus erythematosus, some of them questioning the traditional concepts of systemic lupus erythematosus arthropathy, with potential clinical, prognostic and therapeutic implications. In daily clinical practice, the use of ultrasound in the assessment of joint and tendon involvement in patients with systemic lupus erythematosus is still limited. Several methodological issues encountered in ultrasound studies evaluating musculoskeletal involvement in systemic lupus erythematosus patients need to be addressed in order to improve both the reliability and clinical usefulness of ultrasound findings. This paper reviews ultrasound studies assessing musculoskeletal involvement in patients with systemic lupus erythematosus, highlighting certainty, limits, potential applications and future perspectives of ultrasound use in systemic lupus erythematosus patients.
肌肉骨骼表现是红斑狼疮患者中非常常见的。即使没有关节或肌腱炎症的临床迹象，也经常会出现短暂性和转移性关节炎。在不到 15%的患者中，关节可能会受到更严重的影响，出现变形（雅格关节病）和/或侵蚀性关节炎（狼疮综合征）。近年来，超声已成为评估红斑狼疮肌肉骨骼受累的一种很有前途的成像技术，已证明其能够在关节和关节周围水平检测炎症和结构损伤。最近的超声研究还揭示了红斑狼疮患者肌肉骨骼受累的新见解，其中一些对红斑狼疮关节炎的传统概念提出了质疑，具有潜在的临床、预后和治疗意义。在日常临床实践中，超声在评估红斑狼疮患者关节和肌腱受累中的应用仍然有限。为了提高超声检查结果的可靠性和临床实用性，需要解决在评估红斑狼疮患者肌肉骨骼受累的超声研究中遇到的几个方法学问题。本文综述了评估红斑狼疮患者肌肉骨骼受累的超声研究，强调了超声在红斑狼疮患者中的应用的确定性、局限性、潜在应用和未来前景。
