Martinez Jessica A, Taljanovic Mihra S, Nuncio Zuniga Andres A, Wertheim Betsy C, Roe Denise J, Ehsani Sima, Jiralerspong Sao, Segar Jennifer, Chalasani Pavani
The University of Arizona Cancer Center, Tucson, AZ 85719, USA.
Department of Nutritional Sciences, University of Arizona, Tucson, AZ 85719, USA.
J Clin Med. 2022 Feb 18;11(4):1067. doi: 10.3390/jcm11041067.
Aromatase inhibitor-induced arthralgia (AIA) comprises significant, activity-limiting musculoskeletal symptoms, including joint pain, myalgia, and joint stiffness. We conducted a prospective feasibility study in postmenopausal women diagnosed with early-stage (0-3) hormone receptor positive (HR+) breast cancer who were candidates for treatment with adjuvant AI therapy ( = 16). Tendons of the hands and wrists and the median nerve were imaged using gray-scale and power Doppler ultrasound (US) and US SWE. Arthralgia symptoms were evaluated using the Breast Cancer Prevention Trial (BCPT) Symptom Checklist musculoskeletal subscale (MS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and stiffness subscales. At baseline, there were significant differences in the SW velocities of tendons between dominant and nondominant hands. Increased velocity in 2 of 6 tendons and the median nerve was associated with greater pain at baseline, whereas slower velocity of the extensor digitorum tendon (suggesting decreased stiffness) was associated with a higher WOMAC stiffness score. Increased SW velocity (suggestive of increased stiffness) at baseline in the abductor pollicis longus tendon was associated with a worsening of all three pain and stiffness measures by 6 months. Future studies should evaluate SWE scores related to AIA outcomes in a larger sample size.
芳香化酶抑制剂引起的关节痛（AIA）包括严重的、限制活动的肌肉骨骼症状，如关节疼痛、肌痛和关节僵硬。我们对诊断为早期（0 - 3期）激素受体阳性（HR +）乳腺癌且适合接受辅助芳香化酶抑制剂治疗的绝经后女性进行了一项前瞻性可行性研究（n = 16）。使用灰阶和能量多普勒超声（US）以及超声剪切波弹性成像（US SWE）对手腕部肌腱和正中神经进行成像。使用乳腺癌预防试验（BCPT）症状清单肌肉骨骼亚量表（MS）以及西安大略和麦克马斯特大学骨关节炎指数（WOMAC）疼痛和僵硬亚量表评估关节痛症状。在基线时，优势手和非优势手的肌腱剪切波速度存在显著差异。6条肌腱中的2条以及正中神经的速度增加与基线时更严重的疼痛相关，而指伸肌腱速度较慢（提示僵硬程度降低）与更高的WOMAC僵硬评分相关。拇长展肌肌腱在基线时剪切波速度增加（提示僵硬增加）与6个月时所有三项疼痛和僵硬指标的恶化相关。未来的研究应以更大样本量评估与AIA结局相关的剪切波弹性成像评分。
