- 期刊
- OpenAccess
Musculoskeletal Ultrasonography Identifies Structural Damage in Chronic Kidney Disease Patients with Gouty Arthritis
摘要
Background: Renal insufficiency reduces the excretion of uric acid and inflammatory factors and exacerbates the structural deformities caused by gouty arthritis. Musculoskeletal ultrasonography (MSKUS) is often used to evaluate the severity and inflammatory progression of gout. Aim: We aimed to determine whether ultrasound help to identify structural damage in patients with chronic kidney disease (CKD) and gout. Methods: This was a retrospective review of the clinical manifestations and abnormalities observed with MSKUS in 280 patients with gouty arthritis between August 2004 and April 2017. MSKUS identified intra‑articular features, including joint effusion, synovial proliferation, Baker's cysts, double contour sign, tophi, and extra‑articular tenosynovitis. Serum and synovial fluid were collected and analyzed. Significant differences were identified using the Pearson correlation coefficient and independent t‑test. Results: This retrospective cohort included 257 men (91.8%) and 23 women (8.2%) with a mean age of 54.6 years. CKD stage correlated positively with the presence of joint Baker's cyst (P = 0.004). Notably, serum estimated glomerular filtration rate correlated negatively with serum C‑reactive protein level in patients with CKD (P < 0.001), and more severe CKD correlated with a higher prevalence of Baker's cyst in CKD patients (P = 0.0037). Conclusion: Insufficient control of hyperuricemia can lead to chronic gouty arthritis and subsequent structural deformities. Reciprocally, acute inflammation of joints is downregulated as chronic gouty arthritis develops. Patients with hyperuricemia and CKD should receive regular MSKUS examination to avoid the progression of structural damage in the joints.
延伸閱讀
- 許金川、余瑞雲、王德宏、王正一、宋瑞樓、陳定信、賴明陽（1980）。Ultrasonography in the Diagnosis of Intrahepatic Stones。當代醫學，(82)，716-716。https://doi.org/10.29941/MT.198008.0007
- Lin, T. C., Chou, H. L., Chiou, H. J., Chiu, C. M., Chou, C. L., & Chan, R. C. (2009). Application of High-resolution Ultrasonography for the Diagnosis of a Case with Sports-related Sural Neuritis. Journal of Medical Ultrasound, 17(3), 178-182. https://www.airitilibrary.com/Article/Detail?DocID=09296441-200909-17-3-178-182-a
- 蔡凱倫、張棋楨、邱啟勝、張又升（2012）。Clinical Utility of Musculoskeletal Ultrasound in Rheumatic Diseases。內科學誌，23(5)，318-323。https://doi.org/10.6314/JIMT.2012.23(5).02
- Huang, Y. S., Cheng, T. T., Chang, C. H., Hsu, C. S., Lee, C. T., Chiou, T. T. Y., Lai, H. M., Cheng, B. C., Chien, Y. S., & Chuang, F. R. (2009). Clinical Features of Sonography-Diagnosed Gouty Nephropathy: Analysis of 151 Cases in a Medical Center. Acta Nephrologica, 23(1), 15-20. https://www.airitilibrary.com/Article/Detail?DocID=10131671-200903-23-1-15-20-a
- 程明山、周宜宏、許重權、王萬龍、黃慶元、刁翠美、陳明村、張遵（1988）。SONOGRAPHY IN THE EVALUATION OF COMPLICATIONS OF RENAL STONES TREATED BY EXTERACORPOREAL SHOCK-WAVE LITHOTRIPSY。中華放射線醫學雜誌，13(2)，181-186。https://www.airitilibrary.com/Article/Detail?DocID=10188940-198806-201809210019-201809210019-181-186