Alasaarela E M, Alasaarela E L
Päivärinne Hospital, Muhos, Finland.
J Rheumatol. 1994 Sep;21(9):1642-8.
To provide more information about various types of rheumatoid involvement of the painful shoulder by ultrasonography (US).
US examinations were performed in 44 patients (88 shoulders) with rheumatoid arthritis (RA). The technique of shoulder ultrasonography was standardized in studies of 30 healthy volunteers (60 shoulders) without shoulder complaints. US findings were compared with clinical, laboratory and radiographic data to find any relationship.
Sonography could reveal inflammatory conditions at early stages of RA when no radiographic changes were seen. The most common US finding was subacromial-subdeltoid bursitis in 61 shoulders (69%) of 35 patients. Synovitis in the glenohumeral joint was seen in 51 shoulders (58%) of 32 patients, biceps tendinitis in 50 shoulders (57%) of 29 patients and changes in the supraspinatus tendon in 29 shoulders (33%) of 20 patients. There were multiple rheumatoid symptoms in 61 shoulders (69%), one condition resulted in changes in 17 shoulders (19%) and no visible US findings in 10 shoulders (11%). Clinical findings were rather unspecific. Flexion, abduction and outward rotation were often restricted in shoulder symptoms, whereas inward rotation was rarely limited. Shoulder swelling indicated subacromial-subdeltoid bursitis.
Ultrasonography is a very useful method for rheumatologists and orthopedists to see inside joints. It can provide remarkable help for local injection therapy and for planning surgery because of its suitability for evaluation of the extent of rheumatoid disease.
通过超声检查（US）提供更多关于疼痛性肩部类风湿性病变各种类型的信息。
对44例类风湿性关节炎（RA）患者（88个肩部）进行了超声检查。在30名无肩部不适的健康志愿者（60个肩部）的研究中对肩部超声检查技术进行了标准化。将超声检查结果与临床、实验室和放射学数据进行比较以找出任何关联。
超声检查能够在类风湿性关节炎早期未见放射学改变时发现炎症情况。最常见的超声检查发现是35例患者的61个肩部（69%）出现肩峰下-三角肌下滑囊炎。32例患者的51个肩部（58%）出现盂肱关节滑膜炎，29例患者的50个肩部（57%）出现肱二头肌肌腱炎，20例患者的29个肩部（33%）出现冈上肌腱改变。61个肩部（69%）存在多种类风湿症状，一种情况导致17个肩部（19%）出现改变，10个肩部（11%）未见明显超声检查发现。临床发现相当不具特异性。肩部症状时，屈曲、外展和外旋常受限，而内旋很少受限。肩部肿胀提示肩峰下-三角肌下滑囊炎。
超声检查对于风湿病学家和骨科医生观察关节内部情况是一种非常有用的方法。由于其适用于评估类风湿疾病的范围，它可为局部注射治疗和手术规划提供显著帮助。
