Ultrasound-detected lumps in synovial fluid, a sonographic finding associated with non-inflammatory joint effusion.

IF 3.4 4区 医学 Q2 RHEUMATOLOGY
Julio Ramírez, Collin Dexter Adao-Abe, Anastasia Mocritcaia, Adriá Garcia-Gargallo, Joshua Peñafiel-Sam, Claudia Arango, Juan Camilo Sarmiento-Monroy, Helena Flórez, José Alfredo Gómez-Puerta, Lucía Alascio, Ana Belén Azuaga-Piñango
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引用次数: 0

Abstract

Objectives: Joint aspiration plays a crucial role in diagnosis and relieves symptoms but may be unnecessary in some cases. Identifying substitute indicators for synovial white blood cell (WBC) counts could provide alternatives. This study aimed to evaluate US-detected lumps (small hyperechoic structures detached from the synovium) in synovial fluid (SF) as potential diagnostic markers for non-inflammatory joint effusion.

Methods: We carried out a cross-sectional study. Consecutive patients with synovial effusion were selected. US, joint aspiration and analysis of the WBC count of the effusion were performed. Patients with crystal deposits were excluded. Lumps were defined as US small hyperechoic spots within the SF. Sensitivity, specificity, and ROC analysis determined the utility of lumps in distinguishing non-inflammatory from inflammatory effusions.

Results: A total of 108 patients with symptomatic synovial effusion underwent US imaging and joint aspiration (88.8% were knees). Before the joint aspiration, the clinician attributed the joint effusion to degenerative joint disease in 59 patients (54.6%) and inflammatory conditions in 49 patients (45.4%) based on previous imaging tests. Following the joint aspiration, non-inflammatory effusion (<2,000 cells/mm³) was observed in 54 patients (50%). US lumps were present in 40 patients (37%), predominantly with non-inflammatory SF (85%). SF with lumps had a lower mean WBC count (1,043 vs. 8,644 cells/mm³, p=0.0001). US lumps demonstrated diagnostic value for non-inflammatory effusion, with an AUC of 0.835, sensitivity of 65.3%, and specificity of 89.3%.

Conclusions: US lumps in SF are strongly associated with non-inflammatory joint effusion. Their detection indicates low WBC counts, potentially reducing the need for joint aspiration, especially in patients with mild symptoms or hard-to-access joints.

超声检测到滑液中 肿块 ,  超声 发现与非炎症性关节积液相关。
目的:关节抽吸在诊断和缓解症状中起着至关重要的作用,但在某些情况下可能是不必要的。确定滑膜白细胞(WBC)计数的替代指标可以提供替代方法。本研究旨在评估滑膜液(SF)中us检测到的肿块(滑膜分离的小高回声结构)作为非炎症性关节积液的潜在诊断标志物。方法:我们进行了横断面研究。选择连续的滑膜积液患者。进行US,联合抽吸和积液WBC计数分析。排除有晶体沉积的患者。肿块被定义为SF内的US小的高回声点。敏感性、特异性和ROC分析确定了肿块在区分非炎性积液和炎性积液中的效用。结果:共有108例有症状的滑膜积液患者行超声显像和关节抽吸(88.8%为膝关节)。在关节抽吸前,临床医生根据之前的影像学检查,将59例(54.6%)患者的关节积液归因于退行性关节疾病,49例(45.4%)患者的关节积液归因于炎症。结论:SF中的US肿块与非炎症性关节积液密切相关。它们的检测表明白细胞计数低,可能减少关节抽吸的需要,特别是在症状轻微或难以接触关节的患者中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.10
自引率
18.90%
发文量
377
审稿时长
3-6 weeks
期刊介绍: Clinical and Experimental Rheumatology is a bi-monthly international peer-reviewed journal which has been covering all clinical, experimental and translational aspects of musculoskeletal, arthritic and connective tissue diseases since 1983.
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