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首页> 外文期刊>Rheumatology international. >Ultrasonography of the glenohumeral joints--a helpful instrument in differentiation in elderly onset rheumatoid arthritis and polymyalgia rheumatica.
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Ultrasonography of the glenohumeral joints--a helpful instrument in differentiation in elderly onset rheumatoid arthritis and polymyalgia rheumatica.

机译：盂肱关节的超声检查-一种有助于区分老年发作性类风湿关节炎和风湿性多肌痛的有用工具。

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摘要

In a prospective study, the glenohumeral joints of 51 patients (aged 60 or above) were examined, using ultrasonography. Twenty-two patients were suffering from characteristic polymyalgia rheumatica (PMR) symptoms. In contrast, 29 other patients initially had similar complaints, but were diagnosed as having elderly onset rheumatoid arthritis (EORA, rheumatoid factor negative) upon development of typical symptoms. Ultrasound examination revealed glenohumeral joint inflammation in 40.9% (9/22) of the patients with PMR and 65.5% (19/29) of the patients with EORA. A discrete symmetrical biceps tendon sheath effusion was found in only three patients and unilateral in six patients with PMR. In contrast, 12 patients with EORA presented a massive effusion of the biceps tendon sheath, in some cases combined with a bilateral subdeltoid bursitis, and an intraarticular (i.a.) effusion/synovitis. To summarize our results: an i.a. effusion/synovitis, subdeltoid bursitis and biceps tendon sheath effusion were more frequent in patients with EORA, with a predominate symmetry and signs for massive inflammation. The typical ultrasonographic result in patients with PMR was a unilateral inflammation of the glenohumeral joint with predominate discrete biceps tendon sheath effusion and, in comparison with the EORA group, with signs of a low grade inflammation. We conclude that the results of our prospective study might be helpful in the differentiation of PMR and a rheumatoid factor negative subgroup of EORA at the first time of manifestation where clinical overlaps can be observed. However, ultrasonography of the glenohumeral joints might be a good and helpful instrument of differentiation in both diseases.
机译：在一项前瞻性研究中，使用超声检查检查了51例（60岁或以上）患者的盂肱关节。 22名患者患有典型的风湿性多肌痛（PMR）症状。相比之下，其他29位患者最初有类似的主诉，但在典型症状出现时被诊断为患有老年发作的类风湿关节炎（EORA，类风湿因子阴性）。超声检查显示，PMR患者的盂肱关节发炎率为40.9％（9/22），EORA患者为65.5％（19/29）。仅在三例患者中发现了离散的对称性二头肌腱鞘积液，在六例PMR患者中发现了单侧性。相反，有12例EORA患者表现出肱二头肌腱鞘大量积液，在某些情况下还伴有双侧三角肌下滑囊炎和关节内积液/滑膜炎。总结我们的结果：积液/滑膜炎，三角肌滑囊炎和二头肌腱鞘积液在EORA患者中更为常见，具有明显的对称性和严重炎症迹象。 PMR患者的典型超声检查结果是肩肱关节的单侧炎症，主要表现为离散的二头肌腱鞘积液，与EORA组相比，表现为轻度炎症迹象。我们得出结论，我们的前瞻性研究结果可能有助于在首次出现临床重叠的表现时，对EORA的PMR和类风湿因子阴性亚组进行分化。但是，盂肱关节的超声检查可能是区分这两种疾病的好方法。

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