Rheumatology Department, DMU Locomotion, Bichat Hospital (AP-HP), 46, rue Henri-Huchard, 75018 Paris, France.
Rheumatology Department, DMU Locomotion, Bichat Hospital (AP-HP), 46, rue Henri-Huchard, 75018 Paris, France.
Joint Bone Spine. 2024 Jan;91(1):105649. doi: 10.1016/j.jbspin.2023.105649. Epub 2023 Oct 4.
To compare the ultrasonography (US) assessment of the retinacula of ankles in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA).
This cross-sectional study included RA or PsA patients with ankle pain and healthy controls. The following US features were recorded: presence of synovitis, tenosynovitis and abnormalities of two retinacula (the superior peroneal retinaculum [SPR] and the flexor retinaculum [FR] evaluated in mode B and power Doppler).
Among the 80 included patients, 37 (46%) and 23 (29%) had RA and PsA; 20 (25%) patients were healthy controls. The FR was thicker in PsA than RA ankles 0.96±0.39 vs. 0.64±0.15, P<0.001 with no difference between RA patients and HCs. Other FR abnormalities such as hypoechogenicity, PD positivity or periostosis were more frequent in PsA than RA patients, P<0.001. On receiver-operating-characteristic curve analysis, a cut-off of 1mm FR thickness provided a sensitivity of 49% and specificity of 97% for the diagnosis of PsA. Overall, 39 and 3% of PsA and RA ankles exhibited retinaculitis of FR (thickness≥1mm with hypervascularization or hypoechogenicity). The two disease groups did not differ in the evaluation of SPR.
US abnormalities of FR were more frequent in PsA than RA and appeared to be specific for PsA. US assessment of FR might be useful to distinguish RA and PsA.
比较类风湿关节炎（RA）和银屑病关节炎（PsA）患者踝关节支持带的超声（US）评估。
本横断面研究纳入了有踝关节疼痛的 RA 或 PsA 患者和健康对照者。记录以下 US 特征：滑膜炎、腱鞘炎和两条支持带（在 B 模式和能量多普勒下评估的上腓侧支持带 [SPR] 和屈肌支持带 [FR]）异常。
在纳入的 80 例患者中，37 例（46%）和 23 例（29%）患有 RA 和 PsA；20 例（25%）为健康对照者。与 RA 踝关节相比，PsA 的 FR 更厚 0.96±0.39 vs. 0.64±0.15，P<0.001，而 RA 患者与 HCs 之间无差异。与 RA 患者相比，PsA 患者 FR 的其他异常，如低回声、PD 阳性或骨膜炎更常见，P<0.001。在受试者工作特征曲线分析中，FR 厚度为 1mm 的截断值对 PsA 的诊断具有 49%的敏感性和 97%的特异性。总体而言，39%和 3%的 PsA 和 RA 踝关节存在 FR 腱鞘炎（厚度≥1mm 伴高血管化或低回声）。两种疾病组在 SPR 的评估中没有差异。
与 RA 相比，PsA 的 FR 超声异常更常见，似乎对 PsA 具有特异性。FR 的 US 评估可能有助于区分 RA 和 PsA。
