文章摘要
戴号 陈雁西 徐岳林 马迎辉 毛剑莹 陆玲玲.类风湿关节炎拇长屈肌腱病变的超声特点[J].,2014,14(27):5274-5276
类风湿关节炎拇长屈肌腱病变的超声特点
Study on the Characteristic of Ultrasound of Flexor Hallucis Longus TendonChanges in Patients with Rheumatoid Arthritis
  
DOI:
中文关键词: 类风湿关节炎  拇长屈肌腱  超声
英文关键词: Rheumatoid arthritis  Flexor hallucis longus  Ultrasound
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作者单位
戴号 陈雁西 徐岳林 马迎辉 毛剑莹 陆玲玲 同济大学附属东方医院创伤骨科上海市长宁区光华中西医结合医院关节外科 
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中文摘要:
      目的:总结类风湿关节炎(RA)患者拇长屈肌腱(FHL)病变的超声特点及二者间的相关性。方法:回顾性分析2010 年2 月至 2011 年6月因足部疼痛于我院就诊的60 例(120 足)RA 患者资料。应用彩色多普勒超声诊断仪探查拇长屈肌腱,根据超声探查 拇长屈肌腱病变情况的结果将患者分为3 组:肌腱完整组(A 组,45 足),肌腱周围炎症组(B 组,49 足),肌腱断裂组(C 组,26 足)。对拇长屈肌腱病变的特点及部位进行描述,并将拇长屈肌腱病变严重程度与患者年龄及病程进行相关性分析。结果:45 足肌 腱完整,49 足出现不同部位的肌腱周围炎症(内踝转折处17 足,henrry’s结节处11 足,第一跖趾关节跖侧21 足),26 足发生肌腱 断裂(9 足发生于内踝转折处,17 足发生于跖趾关节跖侧)。肌腱病变的发生率71%。A 组平均年龄49.9± 9.2 岁,病程4.7± 2.6 年;B 组平均年龄56.2± 9.2 岁,病程16.2± 7.4 年;C 组平均年龄54.7± 8.0 岁,病程20.9± 4.4 年。三组间上述参数差异具有统计 学意义(P<0.05)。结论:拇长屈肌腱是类风湿关节炎足部结构的常见受累部位,其病变多发生于内踝转折处,henrry's 结节处及第 一跖趾关节跖侧,但henrry’s结节处的断裂少见。在对类风湿关节炎平足患者进行肌腱转位手术时,应充分考量拇长屈肌腱的病 变。
英文摘要:
      Objective:To a summarize the characteristic of ultrasound of flexor hallucis longus (FHL) tendon changes in patients with rheumatoid arthritis (RA).Methods:From February 2010 to June 2012, 60 RA patients (120 feet) with painful feet were analyzed. Color doppler ultrasound was used to examine the FHL, and the FHL changes were divided into 3 groups in accordance with the results of ultrasound examination. Group A with normal FHL included 45 feet, group B with FHL tenosynovitis included 49 feet, and group C with FHL rupture included 26 feet. Characteristics and position of FHL tendon changes were described, the relationship between severity of FHL tendon changes and age, duration were analyzed.Results:There was 45 feet with normal FHL, 49 feet with FHL tenosynovitis (17 feet in hinge part of malleolus medialis, 11 feet in Henrry's nodules, 21 feet in first metatarsophalangeal joint at the plantar side), 26 feet with FHL rupture (9 feet in hinge part of malleolus medialis, 11 feet in Henrry's nodules, 17 feet in metatarsophalangeal joint at the plantar side). The incidence of FHL tendon changes was 71%. The mean age in group A was 49.9± 9.2 yr vs 56.2± 9.2 yr in group B and 54.7± 8.0 yr in group C. The mean duration was 4.7± 2.6 yr vs 16.2± 7.4 ys and 20.9± 4.4 yr, significant statistics difference among these parameters were found between groups (P<0.05).Conclusion:FHL is the common affected foot structure in RA, mainly occur in hinge part of malleolus medialis, Henrry's nodules, and metatarsophalangeal joint at the plantar side, but is not uncommon of FHL rupture in Henrry's nodules. We should consider and discuss the FHL change when muscle tendon transposition repairing were performed in RA patients with Pes planus.
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