Tsampoulas C G, Skopouli F N, Sartoris D J, Kaplan P, Kursunoglu S, Pineda C, Resnick D, Moutsopoulos H M
Scand J Rheumatol. 1986;15(3):333-9. doi: 10.3109/03009748609092600.
Unselected hand radiographs from 37 primary Sjögren's syndrome patients (pSS), 19 patients with rheumatoid arthritis (RA) and Sjögren's syndrome (secondary SS) and 29 patients with RA only were evaluated blind by osteoradiologists, using reference radiographs for scoring joint space narrowing and erosion at the proximal interphalangeal joints, the metacarpophalangeal joints and the wrists. A history of arthralgias and/or arthritis of the above joints was taken from the patients charts. It is shown that pSS patients suffer from transient episodes of arthralgias and/or arthritis, while both secondary SS and RA patients had a history of chronic arthritis of the small joints of the hand. Evaluation of the hand radiographs showed that pSS patients exhibited mild joint space narrowing but no erosions, whereas the other two groups of patients presented with more severe joint space narrowing and varying degrees of erosions. Finally, RA patients without SS had more advanced radiographic changes than secondary SS patients. Thus hand X-rays can be used in addition to the previously described clinical differences in the differentiation of primary and secondary SS.
37例原发性干燥综合征（pSS）患者、19例类风湿关节炎（RA）合并干燥综合征（继发性SS）患者以及29例单纯RA患者的手部X线片由骨放射科医生进行盲法评估，使用对照X线片对近端指间关节、掌指关节和腕关节的关节间隙狭窄和骨质侵蚀进行评分。从患者病历中获取上述关节的关节痛和/或关节炎病史。结果显示，pSS患者有短暂的关节痛和/或关节炎发作，而继发性SS患者和RA患者均有手部小关节慢性关节炎病史。手部X线片评估显示，pSS患者表现为轻度关节间隙狭窄但无骨质侵蚀，而其他两组患者关节间隙狭窄更严重且有不同程度的骨质侵蚀。最后，无SS的RA患者的影像学改变比继发性SS患者更严重。因此，除了先前描述的临床差异外，手部X线检查可用于原发性和继发性SS的鉴别诊断。
