老年性类风湿关节炎肩关节的影像学表现

doi:10.3969/j.issn.1003-9198.2024.02.019

摘要/Abstract

摘要： 类风湿关节炎(RA)是以小关节受累为特征的风湿性疾病,老年性类风湿关节炎(EORA)以大关节受累为首发症状,EORA病人肩部受累通常不明显,临床表现没有特异性,肩关节的影像学表现便成为诊断RA的重要辅助工具。本综述介绍EORA病人不同影像学检查中肩关节的表现,讨论不同技术的优劣性,希望使临床深入了解影像学在肩关节受累的RA诊疗中的作用。

关键词: 老年人, 类风湿关节炎, 肩关节, 影像学表现

中图分类号:

R 593.22

褚子静, 张忠新. 老年性类风湿关节炎肩关节的影像学表现[J]. 实用老年医学, 2024, 38(2): 185-188.

[1] ANDERSSON M L, SVENSSON B, FORSLIND K. Distribution of erosions in hands and feet at the time for the diagnosis of RA and during 8-year follow-up [J]. Clin Rheumatol, 2021, 40(5): 1799-1810.
[2] SOUBRIER M, MATHIEU S, PAYET S, et al. Elderly-onset rheumatoid arthritis [J]. Joint Bone Spine, 2010, 77(4): 290-296.
[3] MURATA K, ITO H, HASHIMOTO M, et al. Elderly onset of early rheumatoid arthritis is a risk factor for bone erosions, refractory to treatment: KURAMA cohort [J]. Int J Rheum Dis, 2019, 22(6): 1084-1093.
[4] SHARIF K, SHARIF A, JUMAH F, et al. Rheumatoid arthritis in review: clinical, anatomical, cellular and molecular points of view [J]. Clin Anat, 2018, 31(2): 216-223.
[5] SERHAL L, LWIN M N, HOLROYD C, et al. Rheumatoid arthritis in the elderly: characteristics and treatment considerations [J]. Autoimmun Rev, 2020, 19(6): 102528.
[6] MA Z, ZOU H, YELOVICH M, et al. Prevalence and trajectory of erosions, synovitis, and bone marrow edema in feet of patients with early rheumatoid arthritis [J]. Clin Rheumatol, 2021, 40(9): 3575-3579.
[7] CHEN W, WANG Q, KE Y, et al. Neutrophil function in an inflammatory milieu of rheumatoid arthritis [J]. J Immunol Res, 2018, 2018: 8549329.
[8] VAN VOLLENHOVEN R F. Unresolved issues in biologic therapy for rheumatoid arthritis [J]. Nat Rev Rheumatol, 2011, 7(4): 205-215.
[9] ROMAO V C, HUMBY F, KELLY S, et al. Treatment-resistant synovitis and radiographic progression are increased in elderly-onset rheumatoid arthritis patients: findings from a prospective observational longitudinal early arthritis cohort study [J]. Semin Arthritis Rheum, 2020, 50(4): 735-743.
[10] 李雄根, 郑伯良, 梁维基, 等. 老年性类风湿性关节炎的诊治初探 [J]. 临床荟萃, 1997, 12(6): 257-258.
[11] CUOMO F, GRELLER M J, ZUCKERMAN J D. The rheumatoid shoulder [J]. Rheum Dis Clin North Am, 1998, 24(1): 67-82.
[12] THOMAS T, NOËL E, GOUPILLE P, et al. The rheumatoid shoulder: current consensus on diagnosis and treatment [J]. Joint Bone Spine, 2006, 73(2): 139-143.
[13] 何芳, 尚华, 汪佳利. 老年性类风湿性关节炎的回顾性分析 [J]. 环球中医药, 2013, 6(S2): 42-43.
[14] MURAKAMI D M, BASSETT L W, SEEGER L L. Advances in imaging of rheumatoid arthritis [J]. Clin Orthop Relat Res, 1991, 265: 83-95.
[15] 申勇, 刘时璋, 翟腾飞, 等. 中老年退行性肩袖撕裂患者肩峰指数、肩肱距离与年龄的相关性 [J]. 中国组织工程研究, 2023, 27(31): 5040-5045.
[16] 金日龙, 杨骥, 张驰, 等. 老年肩袖损伤的特点及治疗进展 [J]. 中华老年骨科与康复电子杂志, 2017, 3(3): 188-192.
[17] DEJACO C, DUFTNER C, WIPFLER-FREISSMUTH E, et al. Elderly- versus younger-onset rheumatoid arthritis: higher levels of ultrasound-detected inflammation despite comparable clinical disease activity [J]. Arthritis Care Res: Hoboken, 2013, 65(2): 304-308.
[18] ABDELZAHER M G, THARWAT S, ABDELKHALEK A, et al. Ultrasound versus magnetic resonance imaging in the evaluation of shoulder joint pathologies in a cohort of rheumatoid arthritis patients [J]. Int J Rheum Dis, 2019, 22(12): 2158-2164.
[19] SUZUKI T, YOSHIDA R, OKAMOTO A, et al. Semiquantitative evaluation of extrasynovial soft tissue inflammation in the shoulders of patients with polymyalgia rheumatica and elderly-onset rheumatoid arthritis by power doppler ultrasound [J]. Biomed Res Int, 2017, 2017: 4272560.
[20] SUGIHARA T. Treatment strategies for elderly-onset rheumatoid arthritis in the new era [J]. Mod Rheumatol, 2022, 32(3): 493-499.
[21] D'AGOSTINO M A, TERSLEV L, AEGERTER P, et al. Scoring ultrasound synovitis in rheumatoid arthritis: a EULAR-OMERACT ultrasound taskforce-Part 1: definition and development of a standardised, consensus-based scoring system [J]. RMD Open, 2017, 3(1): e000428.
[22] ENDO T, MATSUI Y,KAWAMURA D, et al. Diagnostic utility of superb microvascular imaging and power doppler ultrasonography for visualizing enriched microvascular flow in patients with carpal tunnel syndrome [J]. Front Neurol, 2022, 13: 832569.
[23] CAI X H, YANG S P, SHEN H L, et al. Application of contrast-enhanced ultrasonography and ultrasonography scores in rheumatoid arthritis [J]. Int J Clin Exp Med, 2015, 8(11): 20056-20064.
[24] SPERLING J W, COFIELD R H, SCHLECK C D, et al. Total shoulder arthroplasty versus hemiarthroplasty for rheumatoid arthritis of the shoulder: results of 303 consecutive cases [J]. J Shoulder Elbow Surg, 2007, 16(6): 683-690.
[25] 万绍芬. 老年类风湿关节炎临床特点与影像学诊断 [J]. 中国当代医药, 2009, 16(20): 70.
[26] AMIN M F, ISMAIL F M, EL SHEREEF R R. The role of ultrasonography in early detection and monitoring of shoulder erosions, and disease activity in rheumatoid arthritis patients; comparison with MRI examination [J]. Acad Radiol, 2012, 19(6): 693-700.
[27] SASAKI K, MORIHARA T,KIDA Y, et al. Visualization of rotator cuff tear morphology by radial magnetic resonance imaging [J]. Clin Imaging, 2018, 50: 264-272.
[28] 罗美兵. 磁共振平扫与磁共振关节造影在肩袖撕裂诊断中的运用价值分析 [J]. 影像研究与医学应用, 2021, 5(17): 68-69.
[29] KAWASHIRI S Y, SUZUKI T, OKADA A, et al. Differences in musculoskeletal ultrasound findings between RS3PE syndrome and elderly-onset rheumatoid arthritis [J]. Clin Rheumatol, 2020, 39(6): 1981-1988.
[30] ALBERTSEN M, EGUND N, JONSSON E, et al. Assessment at CT of the rheumatoid shoulder with surgical correlation [J]. Acta Radiol, 1994, 35(2): 164-168.
[31] 刘雪峰, 伦晓名, 郁万江, 等. QCT与DXA对老年类风湿关节炎患者骨质疏松症诊断价值的对比研究 [J]. 中国骨质疏松杂志, 2021, 27(4): 475-480.
[32] KUBOTA K, YAMASHITA H, MIMORI A. Clinical value of FDG-PET/CT for the evaluation of rheumatic diseases: rheumatoid arthritis, polymyalgia rheumatica, and relapsing polychondritis [J]. Semin Nucl Med, 2017, 47(4): 408-424.
[33] KUBOTA K, ITO K, MOROOKA M, et al. Whole-body FDG-PET/CT on rheumatoid arthritis of large joints [J]. Ann Nucl Med, 2009, 23(9): 783-791.
[34] KENNEDY J S, MYERS H S, GIBSON S D, et al. The validity and reliability of ultrasound on identifying supraspinatus tears during passive external rotation from 0 degrees to 30 degrees : a pilot project [J]. Shoulder Elbow, 2017, 9(1): 54-60.
[35] COLEBATCH A N, EDWARDS C J, ØSTERGAARD M, et al. EULAR recommendations for the use of imaging of the joints in the clinical management of rheumatoid arthritis [J]. Ann Rheum Dis, 2013, 72(6): 804-814.

老年性类风湿关节炎肩关节的影像学表现

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