Mendonça José Alexandre, de Aquino José Luís Braga
Stricto Sensu Postgraduate Program in Health Sciences/Ultrasonography/Rheumatology Service, Pontifical Catholic University of Campinas (PUC-Campinas) School of Life Sciences, Sumare 13175665, São Paulo, Brazil.
Stricto Sensu Postgraduate Program in Health Sciences/Surgery Service, Pontifical Catholic University of Campinas (PUC-Campinas) School of Life Sciences, Campinas 13060-604, São Paulo, Brazil.
World J Radiol. 2025 Aug 28;17(8):109146. doi: 10.4329/wjr.v17.i8.109146.
Ultrasound (US) can be a valuable tool for assessing arthritis associated with inflammatory bowel disease (IBD), especially in cases of psoriatic disease. The clinical case reviewed in this article addresses an exploratory finding that evaluates the effects of immunobiological treatments on dactylitis and IBD with the use of US techniques.
A 40-year-old Caucasian woman with psoriatic arthritis (PsA) and ulcerative colitis (UC) reported experiencing finger pain, knee arthritis, and bloody diarrhea. She showed a high Disease Activity index for PsA score and a severe Mayo score. She began treatment with adalimumab. Over the course of six months, the 18 MHz US procedure was performed on her joints and a 3.5 MHz US on her intestines. The joint US indicated dactylitis and swelling in her finger joints, while the intestinal US revealed 6.6 mm swelling in the sigmoid colon, increased abdominal fat, and high Doppler signal. Her fecal calprotectin level was 5984 mg/kg, and a colonoscopy showed that UC extended to the hepatic flexure, along with mild narrowing of the transverse colon. After six months treatment, all parameters showed improvement, including a remission of the Mayo score, better colonoscopy results, and Limberg score of 0.
More research is needed to find out the importance of using US in patients with PsA and UC as this could improve treatment strategies.
超声（US）可成为评估与炎症性肠病（IBD）相关关节炎的重要工具，尤其是在银屑病性疾病的病例中。本文回顾的临床病例涉及一项探索性发现，该发现利用超声技术评估免疫生物治疗对指（趾）炎和IBD的影响。
一名40岁患有银屑病关节炎（PsA）和溃疡性结肠炎（UC）的白人女性报告有手指疼痛、膝关节炎和血性腹泻。她的PsA疾病活动指数评分较高，梅奥评分严重。她开始使用阿达木单抗治疗。在六个月的疗程中，对她的关节进行了18兆赫的超声检查，对肠道进行了3.5兆赫的超声检查。关节超声显示她的手指关节有指（趾）炎和肿胀，而肠道超声显示乙状结肠有6.6毫米的肿胀、腹部脂肪增加和高多普勒信号。她的粪便钙卫蛋白水平为5984毫克/千克，结肠镜检查显示UC延伸至肝曲，横结肠轻度狭窄。经过六个月的治疗，所有参数均显示改善，包括梅奥评分缓解、结肠镜检查结果更好以及林贝格评分为0。
需要更多研究来确定超声在PsA和UC患者中应用的重要性，因为这可能改善治疗策略。
