风湿性关节炎中的肩部疼痛:超声波发现和临床相关性
Ganesh Kumar1, Raj Kumar1, Abhinav Singh2
1Physical Medicine and Rehabilitation, Indira Gandhi Institute of Medical Sciences, Patna, IND.
Cureus
|June 17, 2025
概括
肩部疼痛影响了一半的类风湿性关节炎 (RA) 患者,通常与胸膜炎或侧关节炎有关. 高分辨率超声波 (HRUS) 有助于识别结构原因,尽管疼痛可以在没有明显异常的情况下持续存在.
科学领域:
- 类风湿病学 类风湿病学
- 肌肉骨成像系统的成像
- 疼痛管理 疼痛管理
背景情况:
- 肩部疼痛是风湿性关节炎 (RA) 的常见但未被研究的症状.
- 在RA患者中,肩部疼痛的确切患病率和结构原因需要进一步调查.
- 高分辨率的肌肉骨超声波 (HRUS) 在评估RA的肩部异常方面未得到充分利用.
研究的目的:
- 为了确定RA患者肩部疼痛的患病率.
- 探索肩膀疼痛与HRUS发现的结构异常之间的关联.
- 为了将临床特征与RA患者的HRUS发现与肩部疼痛相关联.
主要方法:
- 一项涉及208名RA患者的观察性,横截面研究.
- 临床评估包括肩膀疼痛和残疾指数 (SPADI).
- 高分辨率的肌肉骨超声波 (HRUS) 评估肩膀结构.
主要成果:
- 50.48%的RA患者 (105/208) 报告了肩膀疼痛.
- 最常见的HRUS发现是亚体-亚体 (SASD) 囊炎 (47.6%),亚体囊炎 (33.3%),和肌炎 (15.2%).
- 34.3%的肩部疼痛患者没有可检测的HRUS异常;血清阳性与肩部疼痛显著相关.
结论:
- 肩膀疼痛在RA患者中非常普遍.
- 胸膜炎和鼻膜炎是常见的结构性原因,但肩部疼痛可能发生在没有HRUS检测到的异常的情况下.
- 通过HRUS识别的结构异常与RA患者的疼痛严重程度增加和功能障碍相关.
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