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甲状腺功能障碍患者膝关节超声与临床症状之间关系的评估。

Assessment of the relationship between knee ultrasound and clinical symptoms in patients with thyroid dysfunction.

作者信息

Kim Bo Young, Kim Sung-Soo, Park Hyeong Kyu, Kim Hyun-Sook

机构信息

Division of Rheumatology, Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.

Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea.

出版信息

J Int Med Res. 2020 Jan;48(1):300060519897701. doi: 10.1177/0300060519897701.

Abstract

OBJECTIVE

To determine whether musculoskeletal ultrasound (MSUS) abnormalities were associated with thyroid dysfunction.

METHODS

This study included 109 patients with thyroid diseases, including thyroid dysfunction or autoimmune thyroid disease. Patients were categorized as euthyroid, hypothyroid, or hyperthyroid based on their recent thyroid function tests. To evaluate MSUS, an experienced rheumatologist examined the presence of synovial fluid, synovial hypertrophy, and grade of inflammation in both gray-scale and power Doppler scans of the knee joint. Associations between MSUS abnormalities, thyroid status, visual analog scale (VAS) score for knee pain, and presence of thyroid autoantibodies were investigated.

RESULTS

MSUS abnormalities were more frequently associated with hyperthyroid or hypothyroid states than with a euthyroid state. High knee VAS score was significantly associated with overall MSUS severity score regardless of knee osteoarthritis. However, there was no difference in MSUS abnormalities based on the presence of thyroid autoantibodies.

CONCLUSIONS

Both hypothyroid and hyperthyroid states were associated with MSUS abnormalities and knee arthralgia. MSUS examination may be helpful in uncontrolled thyroid dysfunction and knee arthralgia.

摘要

目的

确定肌肉骨骼超声(MSUS)异常是否与甲状腺功能障碍相关。

方法

本研究纳入了109例甲状腺疾病患者,包括甲状腺功能障碍或自身免疫性甲状腺疾病。根据患者近期的甲状腺功能检查结果,将其分为甲状腺功能正常、甲状腺功能减退或甲状腺功能亢进。为评估MSUS,一位经验丰富的风湿病学家在膝关节的灰阶和能量多普勒扫描中检查了滑液、滑膜肥厚和炎症程度。研究了MSUS异常、甲状腺状态、膝关节疼痛视觉模拟量表(VAS)评分和甲状腺自身抗体之间的关联。

结果

与甲状腺功能正常状态相比,MSUS异常更常与甲状腺功能亢进或减退状态相关。无论是否存在膝关节骨关节炎,膝关节高VAS评分均与MSUS总体严重程度评分显著相关。然而,基于甲状腺自身抗体的存在,MSUS异常并无差异。

结论

甲状腺功能减退和亢进状态均与MSUS异常和膝关节疼痛相关。MSUS检查可能有助于诊断未得到控制的甲状腺功能障碍和膝关节疼痛。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98af/7113714/6c2eb8567f81/10.1177_0300060519897701-fig1.jpg

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