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手部类风湿关节炎:第2部分:影像学

[Rheumatoid arthritis of the hand : Part 2: Imaging].

作者信息

Bollow Matthias

机构信息

Klinik für diagnostische und interventionelle Radiologie, Augusta-Kranken-Anstalt Bochum, Ruhr-Universität Bochum, Bergstraße 26, 44791, Bochum, Deutschland.

出版信息

Radiologe. 2021 Apr;61(4):362-374. doi: 10.1007/s00117-021-00833-3. Epub 2021 Mar 16.

DOI:10.1007/s00117-021-00833-3
PMID:33728480
Abstract

BACKGROUND

Rheumatoid arthritis can cause joint destruction, especially joints of the hands. Diagnosed at an early stage, which often includes imaging methods, can minimize structural joint damage and resulting disabilities as well as avoid systemic manifestations such as cardiovascular damage through rapid and continuous so-called targeted treatment approaches.

OBJECTIVE

The aim of this work is the systematic description and report of imaging findings in rheumatoid arthritis as the most common autoimmunologic rheumatologic disease, which is characterized by a typical pattern of synovitis of the hands.

MATERIALS AND METHODS

Narrative review based on the current literature on the subject from the radiological and rheumatological point of view.

RESULTS

Inflammation of the hands represents the most frequently affected area of the body in rheumatoid arthritis. Taking into consideration the topology and typical synovitis patterns of the hands, differences between early and late stages are described. Knowledge regarding image-based morphological changes associated with this complex disease, especially in the hands, is important in the differential diagnosis, especially in early stages of the disease.

CONCLUSIONS

For the diagnosis of rheumatoid arthritis of the hands, the radiologist must be familiar with basic knowledge of arthritis in the hands to confidently analyze the typical patterns present in the diagnostic imaging at initial diagnosis and during the course of the disease, which serve as a guide for therapy decisions.

摘要

背景

类风湿关节炎可导致关节破坏,尤其是手部关节。早期诊断(通常包括影像学检查方法)可通过快速且持续的所谓靶向治疗方法,将关节结构损伤及由此导致的残疾降至最低,并避免心血管损伤等全身表现。

目的

本研究旨在系统描述和报告类风湿关节炎(作为最常见的自身免疫性风湿性疾病,其特征为手部典型的滑膜炎模式)的影像学表现。

材料与方法

从放射学和风湿病学角度,基于关于该主题的当前文献进行叙述性综述。

结果

手部炎症是类风湿关节炎中身体最常受累的部位。考虑到手部的解剖结构和典型滑膜炎模式,描述了疾病早期和晚期的差异。了解与这种复杂疾病相关的基于图像的形态学变化,尤其是手部的变化,在鉴别诊断中很重要,特别是在疾病早期。

结论

对于手部类风湿关节炎的诊断,放射科医生必须熟悉手部关节炎的基本知识,以便在初始诊断和疾病过程中自信地分析诊断性影像学中呈现的典型模式,这些模式可作为治疗决策的指导。

相似文献

1
[Rheumatoid arthritis of the hand : Part 2: Imaging].手部类风湿关节炎:第2部分:影像学
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[Rheumatoid arthritis of the hand : Part 1: Clinical aspects].[手部类风湿关节炎:第一部分:临床方面]
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本文引用的文献

1
Clinicopathologic features of rheumatoid nodules: a retrospective analysis.类风湿结节的临床病理特征:一项回顾性分析。
Clin Rheumatol. 2019 Nov;38(11):3041-3048. doi: 10.1007/s10067-019-04668-1. Epub 2019 Jul 4.
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Low-field magnetic resonance imaging offers potential for measuring tibial component migration.低场磁共振成像为测量胫骨部件移位提供了可能。
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The OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging (MRI) Scoring System: Updated Recommendations by the OMERACT MRI in Arthritis Working Group.
OMERACT 类风湿关节炎磁共振成像(MRI)评分系统:OMERACT 关节炎工作组对 MRI 的更新建议。
J Rheumatol. 2017 Nov;44(11):1706-1712. doi: 10.3899/jrheum.161433. Epub 2017 Aug 15.
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High-Resolution US of Rheumatologic Diseases.风湿性疾病的高分辨率超声检查
Radiographics. 2015 Nov-Dec;35(7):2026-48. doi: 10.1148/rg.2015140250.
5
Dynamic Contrast-Enhanced Magnetic Resonance Imaging Using Pharmacokinetic Modeling: Initial Experience in Patients With Early Arthritis.动态对比增强磁共振成像的药代动力学建模:早期关节炎患者的初步经验。
Arthritis Rheumatol. 2016 Mar;68(3):587-96. doi: 10.1002/art.39469.
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Evaluation of magnetic resonance imaging-detected tenosynovitis in the hand and wrist in early arthritis.磁共振成像检测早期关节炎手部和腕部腱鞘炎的评估。
Arthritis Rheumatol. 2015 Apr;67(4):869-76. doi: 10.1002/art.39000.
7
Dynamic contrast-enhanced magnetic resonance imaging of metacarpophalangeal joints reflects histological signs of synovitis in rheumatoid arthritis.掌指关节的动态对比增强磁共振成像反映类风湿关节炎滑膜炎的组织学特征。
Arthritis Res Ther. 2014 Oct 1;16(5):452. doi: 10.1186/s13075-014-0452-x.
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Concordance between inflammation at physical examination and on MRI in patients with early arthritis.早期关节炎患者体格检查与 MRI 检查的炎症一致性。
Ann Rheum Dis. 2015 Mar;74(3):506-12. doi: 10.1136/annrheumdis-2013-204005. Epub 2013 Dec 12.
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Bilateral MR imaging of the hand and wrist in early and very early inflammatory arthritis: tenosynovitis is associated with progression to rheumatoid arthritis.手部和腕部双侧磁共振成像在早期和极早期炎症性关节炎中的应用:腱鞘炎与向类风湿关节炎的进展相关。
Radiology. 2012 Sep;264(3):823-33. doi: 10.1148/radiol.12112513. Epub 2012 Jun 21.
10
Simultaneous evaluation of long-lasting knee synovitis in patients undergoing arthroplasty by power Doppler ultrasonography and contrast-enhanced MRI in comparison with histopathology.关节置换术中超声造影与增强 MRI 对膝关节滑膜炎的对比研究
Clin Exp Rheumatol. 2012 Jan-Feb;30(1):85-92. Epub 2012 Mar 7.