骨骼肌肉超音波在風濕性疾病診療上的應用

Clinical Utility of Musculoskeletal Ultrasound in Rheumatic Diseases

10.6314/JIMT.2012.23(5).02

蔡凱倫(Kai-Len Tsai)；張棋楨(Chi-Ching Chang)；邱啟勝(Chi-Sheng Chiou)；張又升(Yu-Sheng Chang)

骨骼肌肉超音波 ； 風濕性疾病 ； Musculoskeletal ultrasound ； Rheumatic disease

內科學誌

23卷5期（2012 / 10 / 01）

318 - 323

繁體中文

骨骼肌肉超音波（musculoskeletal ultrasound，骨超）已被證實廣泛的應用在各風濕免疫疾病上，包涵協助診斷、疾病追蹤、預後評估及執行介入性檢查。各類骨超研究常與臨床理學檢查、傳統X光片、甚至更昂貴的核磁共振來做比較。除了類風濕性關節早已被證實骨超在偵測滑膜炎與關節骨面侵蝕是相當有效的工具外，血清陰性脊椎關節炎的著骨點病變之首選影像也是骨超。舉凡肌肉、韌帶、周邊神經、軟骨等組織病變亦能由骨超檢查出來。而退化性關節炎與結晶性關節炎骨超的檢查也能拓展臨床醫師的視野以及骨超導引抽取關節液及關節內注射可提高準確率等。除此之外骨超還能幫忙診斷其他結締組織疾病。本文乃回顧及闡述各種不同風濕性疾病如何藉由超音波在診療上的應用。

Musculoskeletal ultrasound (MSUS) had wisely using in rheumatology practice and research, including diagnostic role, prognostic and predictive role, intervetion treatment. MSUS is more sensitive than clinical examination, plain radiography and more feasible than MRI. MSUS is a useful tool in the diagnosis and localization of synovitis and minimal bone erosion in rheumatoid arthritis. Enthesopathy which the most important pathologic finding in seronegative spondyloarthropathy is more sensitive in MSUS then clinical exmaintion. Ligament, muscle, peripheral nerve and cartilage pathology can also be readily demonstrated by MSUS. Osteoarthritis, crystal related arthritis, and wide variety of rheumatic diseases had showed the importance of MSUS findings in assesses treatment response and guide clinical management. This paper reviews the evidence for the application of MSUS in rheumatic disease.