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首页> 外文期刊>Rheumatology >Bone erosions in patients with chronic gouty arthropathy are associated with tophi but not bone oedema or synovitis: New insights from a 3 T MRI study
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Bone erosions in patients with chronic gouty arthropathy are associated with tophi but not bone oedema or synovitis: New insights from a 3 T MRI study

机译：慢性痛风性关节炎患者的骨侵蚀与口疮有关，但与骨水肿或滑膜炎无关：3T MRI研究的新见解

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Objectives. Bone erosion has been linked with tophus deposition in gout but the roles of osteitis (MRI bone oedema) and synovitis remain uncertain. Our aims in this prospective 3 T MRI study were to investigate the frequency of these features in gout and determine their relation to one another. Methods. 3 T MRI scans of the wrist were obtained in 40 gout patients. Scans were scored independently by two radiologists for bone oedema, erosions, tophi and synovitis. Dual-energy CT (DECT) scans were scored for tophi in a subgroup of 10 patients. Results. Interreader reliability was high for erosions and tophi [intraclass correlation coefficients (ICCs) 0.77 (95% CI 0.71, 0.87) and 0.71 (95% CI 0.52, 0.83)] and moderate for bone oedema [ICC = 0.60 (95% CI 0.36, 0.77)]. Compared with DECT, MRI had a specificity of 0.98 (95% CI 0.93, 0.99) and sensitivity of 0.63 (95% CI 0.48, 0.76) for tophi. Erosions were detected in 63% of patients and were strongly associated with tophi [odds ratio (OR) = 13.0 (95% CI 1.5, 113)]. In contrast, no association was found between erosions and bone oedema. Using concordant data, bone oedema was scored at 6/548 (1%) sites in 5/40 patients (12.5%) and was very mild (median carpal score = 1, maximum = 45). In logistic regression analysis across all joints nested within individuals, tophus, but not synovitis, was independently associated with erosion [OR = 156.5 (21.2, >999.9), P<0.0001]. Conclusion. Erosions were strongly associated with tophi but not bone oedema or synovitis. MRI bone oedema was relatively uncommon and low grade. These findings highlight the unique nature of the osteopathology of gout.
机译：目标。骨侵蚀与痛风中的Tophus沉积有关，但骨炎（MRI骨水肿）和滑膜炎的作用仍不确定。我们在这项前瞻性3 T MRI研究中的目的是调查痛风中这些特征的频率并确定它们之间的关系。方法。在40名痛风患者中进行了3次T腕部MRI扫描。两名放射科医生对骨水肿，糜烂，痛风石和滑膜炎分别进行了扫描评分。在10位患者的亚组中，对双能CT（DECT）扫描进行了tophi评分。结果。阅读者的信度对于侵蚀和痛风[内类别相关系数（ICC）0.77（95％CI 0.71，0.87）和0.71（95％CI 0.52，0.83）]高，对于骨水肿[ICC = 0.60（95％CI 0.36， 0.77）]。与DECT相比，MRI对痛风石的特异性为0.98（95％CI 0.93，0.99），敏感性为0.63（95％CI 0.48，0.76）。在63％的患者中检测到糜烂，并且与痛风石密切相关[赔率（OR）= 13.0（95％CI 1.5，113）]。相反，糜烂和骨水肿之间没有关联。使用一致的数据，在5/40位患者（6.5％）的6/548（1％）个部位进行了骨水肿评分，并且非常轻度（腕腕平均评分= 1，最大值= 45）。在个体内嵌套的所有关节的逻辑回归分析中，天疱疮而非滑膜炎与糜烂独立相关[OR = 156.5（21.2，> 999.9），P <0.0001]。结论。侵蚀与痛风石密切相关，但与骨水肿或滑膜炎无关。 MRI骨水肿相对不常见且等级较低。这些发现突出了痛风骨病理学的独特性质。

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