系统性红斑狼疮的肌肉骨骼受累：107 例受试者的对比增强磁共振成像研究。

Musculoskeletal involvement in systemic lupus erythematosus: a contrast-enhanced magnetic resonance imaging study in 107 subjects.

机构信息

Rheumatology Department, Hospital Clínic de Barcelona, Barcelona, Spain.

Musculoskeletal Radiology Department, Hospital del Mar-Parc de Salut Mar, Barcelona, Spain.

出版信息

Rheumatology (Oxford). 2024 Feb 1;63(2):423-429. doi: 10.1093/rheumatology/kead223.

DOI:10.1093/rheumatology/kead223

PMID:37208172

Abstract

OBJECTIVE

Joint involvement in SLE is the most frequent manifestation and shows a wide heterogeneity. It has not a valid classification and it is often underestimated. Subclinical inflammatory musculoskeletal involvement is not well known. We aim to describe the prevalence of joint and tendon involvement in hand and wrist of SLE patients, either with clinical arthritis, arthralgia or asymptomatic and compare it with healthy subjects using contrasted MRI.

METHODS

SLE patients fulfilling SLICC criteria were recruited and classified as follows: group (G) 1: hand/wrist arthritis, G2: hand/wrist arthralgia, G3: no hand/wrist symptoms. Jaccoud arthropathy, CCPa and RF positivity, hand OA or surgery were excluded. Healthy subjects (HS) were recruited as controls: G4. Contrasted MRI of non-dominant hand/wrist was performed. Images were evaluated following RAMRIS criteria extended to PIP, Tenosynovitis score for RA and peritendonitis from PsAMRIS. Groups were statistically compared.

RESULTS

A total of 107 subjects were recruited (G1: 31, G2:31, G3:21, G4:24). Any lesion: SLE patients 74.7%, HS 41.67%; P 0.002. Synovitis: G1: 64.52%, G2: 51.61%, G3: 45%, G4: 20.83%; P 0.013. Erosions: G1: 29.03%; G2: 54.84%, G3: 47.62%; G4: 25%; P 0.066. Bone marrow oedema: G1: 29.03%, G2: 22.58%, G3: 19.05%, G4: 0.0%; P 0.046. Tenosynovitis: G1: 38.71%; G2: 25.81%, G3: 14.29%, G4: 0.0%; P 0.005. Peritendonitis: G1: 12.90%; G2: 3.23%, G3: 0.0%, G4: 0.0%; P 0.07.

CONCLUSION

SLE patients have a high prevalence of inflammatory musculoskeletal alterations confirmed by contrasted MRI, even if asymptomatic. Not only tenosynovitis but peritendonitis is also present.

摘要

目的

SLE 患者的关节受累是最常见的表现，且具有广泛的异质性。它没有有效的分类，且经常被低估。亚临床炎症性肌肉骨骼受累并不为人所知。我们旨在描述 SLE 患者手部和腕部关节和肌腱受累的患病率，包括有临床关节炎、关节痛或无症状的患者，并使用对比 MRI 与健康受试者进行比较。

方法

我们招募了符合 SLICC 标准的 SLE 患者，并进行如下分组：组（G）1：手/腕关节炎，G2：手/腕关节痛，G3：无手/腕症状。排除 Jaccoud 关节炎、抗 CCP 抗体和 RF 阳性、手骨关节炎或手术。招募健康受试者（HS）作为对照组：G4。对非优势手/腕进行对比 MRI 检查。根据 RAMRIS 标准评估图像，并扩展至 PIP、RA 的肌腱滑膜炎评分和 PsAMRIS 的肌腱周围炎。对各组进行统计学比较。

结果

共纳入 107 名受试者（G1：31 例，G2：31 例，G3：21 例，G4：24 例）。任何病变：SLE 患者 74.7%，HS 41.67%；P<0.002。滑膜炎：G1：64.52%，G2：51.61%，G3：45%，G4：20.83%；P=0.013。侵蚀：G1：29.03%；G2：54.84%，G3：47.62%；G4：25%；P=0.066。骨髓水肿：G1：29.03%，G2：22.58%，G3：19.05%，G4：0%；P=0.046。肌腱滑膜炎：G1：38.71%，G2：25.81%，G3：14.29%，G4：0%；P=0.005。肌腱周围炎：G1：12.90%，G2：3.23%，G3：0.0%，G4：0%；P=0.07。