超声检查对幼年特发性关节炎患儿关节腔内注射前后关节变化的评估
Ultrasonographic evaluation of changes in the joint before and after intra-articular injection in children with juvenile idiopathic arthritis.
作者信息
Turkmen Seyma, Sozeri Betul
机构信息
Department of Pediatric Rheumatology, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkiye.
出版信息
North Clin Istanb. 2024 Jun 24;11(3):241-248. doi: 10.14744/nci.2024.55481. eCollection 2024.
OBJECTIVE
The aim of this study is to ultrasonographically (US) evaluate the course of the knee joint in oligoarticular juvenile idiopathic arthritis (JIA) patients who received intra-articular steroid (IAS) application to the knee joint.
METHODS
237 knee joints of 175 patients with oligoarticular JIA were evaluated retrospectively. The patients were divided into two groups: those who received only IAS therapy and those who were methotrexate to IAS therapy. Synovial fluid grade changes, synovial proliferation in B mode examination and power Doppler (PD) changes were evaluated with musculoskeletal ultrasonography (MSUS) separately for each joint before the treatment and at the 2, 6 and 12 weeks of the treatment.
RESULTS
The percentages of regression in synovial fluid grade at the second, sixth, and 12 weeks were respectively 73.4%, 88.6%, and 89.0% (n=174, 210, 211, respectively). Meanwhile, the percentages of regression in PD grade were 69.2%, 82.7%, and 84.0% (n=164, 196, 199, respectively). At the second, sixth and 12 weeks, the percentage of those with synovial fluid grade 0 was 24.1%, 54.9%, 73.4%, respectively (n=57, 130, 174, respectively), while the percentage of those with PD grade 0 was 39.7%, 67.9%, 80.6%, respectively (n=94,161,191, respectively). The percentage of those without synovial proliferation in the second, sixth and 12 weeks was found to be 26.2%, 54.9%, 73.8% respectively (n=62, 130, 175, respectively). The mean time to regression of synovial fluid, synovial proliferation, and PD in the only IAS group was significantly short. The percentage of synovitis regression was higher in the only IAS group at all weeks. This difference was especially more pronounced in the early period. When the 12-week results were evaluated, there was no difference between the two groups.
CONCLUSION
This study highlights the utility of MSUS in evaluating the early results of IAS therapy applied to the knee joint in oligoarticular JIA patients.
目的
本研究旨在通过超声（US）评估接受膝关节腔内注射类固醇（IAS）治疗的少关节型幼年特发性关节炎（JIA）患者膝关节的病程。
方法
回顾性评估175例少关节型JIA患者的237个膝关节。患者分为两组：仅接受IAS治疗的患者和接受甲氨蝶呤联合IAS治疗的患者。在治疗前以及治疗的第2、6和12周，分别用肌肉骨骼超声（MSUS）对每个关节评估滑液分级变化、B模式检查中的滑膜增生以及能量多普勒（PD）变化。
结果
在第2、6和12周时，滑液分级的消退百分比分别为73.4%、88.6%和89.0%（分别对应n = 174、210、211）。同时，PD分级的消退百分比分别为69.2%、82.7%和84.0%（分别对应n = 164、196、199）。在第2、6和12周时，滑液分级为0的患者百分比分别为24.1%、54.9%、73.4%（分别对应n = 57、130、174），而PD分级为0的患者百分比分别为39.7%、67.9%、80.6%（分别对应n = 94、161、191）。在第2、6和12周时，未出现滑膜增生的患者百分比分别为26.2%、54.9%、73.8%（分别对应n = 62、130、175）。仅接受IAS治疗的组中，滑液、滑膜增生和PD消退的平均时间显著缩短。在所有周数时，仅接受IAS治疗的组中滑膜炎消退的百分比更高。这种差异在早期尤为明显。在评估12周结果时，两组之间没有差异。
结论
本研究强调了MSUS在评估少关节型JIA患者膝关节IAS治疗早期结果方面的实用性。
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