Ogura Takehisa, Katagiri Takaharu, Kameda Hideto
Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Toho University, 2-22-36, Ohashi, Meguro-Ku, Tokyo, 153-8515, Japan.
Inflamm Regen. 2023 Jul 4;43(1):34. doi: 10.1186/s41232-023-00286-2.
This study aimed to provide an overview of ultrasonographic cartilage evaluation in patients with rheumatoid arthritis (RA) and identify research gaps in the utilization of cartilage evaluation.
The study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. A systematic literature search of the PubMed, Embase, and Cochrane Library databases was conducted for articles published up to July 2022 using the search term variations of "cartilage," "ultrasonography," and "rheumatoid arthritis." Studies that included patients with RA who underwent cartilage evaluation by ultrasonography were selected. Articles published in languages other than English and about juvenile idiopathic arthritis were excluded.
Twenty-nine articles were identified. Most were cross-sectional studies (86%), mainly involving the metacarpophalangeal (55%) and knee (34%) joints. Assessments were performed using quantitative, binary, and semi-quantitative methods in 15, 10, and 15 studies, respectively. Reliability assessments were conducted in 10 studies, which showed feasible reliability but were limited to the finger joints. The validity assessment was validated in one study each that compared cartilage thickness measurements with cadaveric specimens and histological and semi-quantitative methods with surgical specimens, respectively. Comparisons with conventional radiography were also performed in six studies, which showed significant correlations. However, there was heterogeneity in the examination and assessment methods, and no adequate longitudinal evaluation was conducted.
This review highlights the need for further research and validation of ultrasonographic cartilage assessment in patients with RA.
本研究旨在概述类风湿关节炎（RA）患者的超声软骨评估情况，并确定软骨评估应用方面的研究空白。
本研究按照系统评价和Meta分析扩展版的范围综述报告规范进行。使用“软骨”“超声检查”和“类风湿关节炎”的搜索词变体，对PubMed、Embase和Cochrane图书馆数据库进行系统文献检索，检索截至2022年7月发表的文章。选择纳入接受超声软骨评估的RA患者的研究。排除非英语发表的文章和关于青少年特发性关节炎的文章。
共识别出29篇文章。大多数是横断面研究（86%），主要涉及掌指关节（55%）和膝关节（34%）。分别有15项、10项和15项研究使用定量、二元和半定量方法进行评估。10项研究进行了可靠性评估，结果显示可靠性可行，但仅限于手指关节。分别有一项研究通过将软骨厚度测量值与尸体标本进行比较，以及将组织学和半定量方法与手术标本进行比较，验证了有效性评估。六项研究还与传统放射摄影进行了比较，结果显示存在显著相关性。然而，检查和评估方法存在异质性，且未进行充分的纵向评估。
本综述强调需要对RA患者的超声软骨评估进行进一步研究和验证。
