小关节炎可以区分类风湿关节炎和银屑病关节炎:手关节和小关节的综合比较超声研究。

IF 1.1 Q4 RHEUMATOLOGY
Archives of rheumatology Pub Date : 2025-03-17 eCollection Date: 2025-03-01 DOI:10.46497/ArchRheumatol.2025.10780
Tanya Sapundzhieva, Lyubomir Sapundzhiev, Anastas Batalov
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引用次数: 0

摘要

目的:探讨手超声(USG)对类风湿关节炎(RA)和银屑病关节炎(PsA)的鉴别价值。患者和方法:对35例PsA患者(男性13例,女性22例;平均年龄:60.9±8.4岁;年龄53 ~ 69岁),RA患者30例(男性10例,女性20例;平均年龄58.4±10.0岁;50至61岁)和20名健康对照者(5名男性,15名女性;平均年龄:55.6±5.8岁;年龄在50 ~ 61岁之间),采用灰度和功率多普勒USG对腕部、肌腱、小肌腱和第二、第三指关节进行评估。结果:用USG对PsA患者的245个关节、RA患者的210个关节和健康对照者的120个关节进行了评估。与PsA患者相比,RA患者的腕关节滑膜炎、指掌伸肌腱和尺腕伸肌腱的腱鞘炎明显更常见(结论:小腱鞘炎是PsA的标志性USG发现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mini-enthesitis can differentiate rheumatoid arthritis from psoriatic arthritis: A comprehensive comparative ultrasound study of the joints and mini-entheses of the hands.

Objectives: This study aimed to explore whether hand ultrasonography (USG) could differentiate between rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients.

Patients and methods: A comprehensive USG of 35 PsA patients (13 males, 22 females; mean age: 60.9±8.4 years; range, 53 to 69 years), 30 RA patients (10 males, 20 females; mean age: 58.4±10.0 years; range, 50 to 61 years), and 20 healthy controls (5 males, 15 females; mean age: 55.6±5.8 years; range, 50 to 61 years) was performed with assessments of the wrist, tendons, mini-entheses, and joints of the second and third finger, both on gray scale and power Doppler USG.

Results: Two hundred forty-five joints of PsA patients, 210 joints of RA patients, and 120 joints of healthy controls were assessed by USG. Wrist joint synovitis and tenosynovitis of the extensor digitorum communis and extensor carpi ulnaris tendon were significantly more common in RA patients compared to PsA patients (p<0.001), detected in 93.30%, 63.30%, and 73.30% versus 57.10%, 14.30%, and 2.90%, respectively. The incidence of tenosynovitis of the flexor tendons at the wrist level was significantly higher in RA patients (p=0.003), detected in 36.70% versus 14.30%. Paratenonitis of the finger extensor tendon at the metacarpophalangeal joints was significantly more prevalent in PsA patients, detected in 85.70% versus 3.30% (p<0.001). Central slip enthesitis at the proximal interphalangeal joint and enthesitis of the distal slip of the extensor tendon at the second and third distal phalanx were exclusively found in PsA patients, occurring in 45.70%, 91.40%, and 71.30%, respectively (p<0.001). Flexor tenosynovitis and pseudotenosynovitis were significantly more prevalent in PsA patients (65.70% and 57.10%, respectively) compared to RA patients (16.70% and 0.00%, respectively; p<0.001). PsA patients had significantly higher thickness of the A1 pulley compared to RA patients (p<0.001).

Conclusion: Mini-enthesitis is a hallmark USG finding in PsA.

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