Discrepancies of ultrasound findings of shoulders in patients with rheumatoid arthritis and polymyalgia rheumatica
10.3760/cma.j.issn.1007-7480.2018.10.005
- VernacularTitle:类风湿关节炎及风湿性多肌痛患者肩关节病变的超声表现
- Author:
Xuerong DENG
1
;
Xiaoying SUN
;
Zhuoli ZHANG
Author Information
1. 100034,北京大学第一医院风湿免疫科
- Keywords:
Arthritis,rheumatoid;
Polymyalgia rheumatic;
Shoulder;
Ultrasound
- From:
Chinese Journal of Rheumatology
2018;22(10):672-674
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the features and discrepancies of the ultrasound findings of shoulders in patients with rheumatoid arthritis (RA) and polymyalgia rheumatica (PMR).Methods Patients with RA and PMR who complained of pain,swelling or limited mobility of shoulder were enrolled for bilateral ultrasound assessment.Inflammatory lesions including long head biceps (LHB) tenosynovitis,subacromial-subdeltoid (SASD) bursitis,tendinosis of supraspinatus (SS) tendon effusion/synovitis in glenohumeral (GH) and acromioclavicular (AC) joints,as well as structural damages including SS tear,bone erosions and osteophytes on humeral head and AC joints were evaluated.Comparison of frequency of ultrasound features between the two groups was analyzed byx2 test.Results A total of 458 shoulders from 192 RA and 37 PMR patients were assessed by ultrasound.In RA patients,the most prevalent inflammatory findings were LHB tenosynovitis (31.3％),followed by SASD bursitis (25％),SS tendinosis (11.5％),AC and GH effusion/synovitis (10.4％ and 5.7％,respectively).LHB tenosynovitis was the most frequent finding in PMR patients (37.8％),followed by SS tendinosis (27％),SASD bursitis (24.3％),AC and GH effusion/synovitis (2.7％ and 0,respectively).Partial or complete tear of SS tendon was found in 9.9％ RA and 8.1％ PMR patients,respectively.SS tendinosis was more frequently presented in PMR than RA patients (x2=6.255,P＜0.05),while GH effusion/synovitis was more common in RA group (x2=3.983,P＜0.05).Bone erosions and osteophytes were common in both groups.SASD bursitis and SS tendinosis appeared to be more unilateral (77.1％ and 77.3％,respectively),while GH effusion/synovitis tended to be bilateral (63.6％) in RA patients.Conclusion Intra-articular inflammatory involvement (GH effusion/synovitis) is more frequent in RA,while peri-articular inflammatory involvement (SS tendinosis) is more frequent in patients with PMR.SASD bursitis and SS tendinosis appears to be unilateral,while GH effusion/synovitis tends to be bilateral in RA patients.
