Value of high-frequency ultrasound in screening for subclinical attachment point inflammation of ankylosing spondylitis
Objective To investigate the value of high-frequency ultrasound for the early diagnosis of subclinical adhesion pointitis in different parts of ankylosing spondylitis(AS).Methods A total of 100 patients with AS attending Gansu Provincial People's Hospital from January 2017 to November 2023 were selected.Fifty patients with clinical adhesion pachydermatitis(divided into 2 groups of patients with subjective symptoms and those with no subjective symptoms but with tenderness),50 patients with subclinical adhesion pachydermatitis(with no subjective symptoms and tenderness,and need to be diagnosed with the help of MRI or ultrasound)and 50 healthy volunteers were grouped according to the world's first clinical practice guideline on screening and assessment of adhesion pachydermatitis in 2022.High-frequency ultrasonography was performed on the proximal plantar fascia,distal Achilles tendon,distal patellar ligament,proximal patellar ligament,distal quadriceps tendon,and triceps tendon attachment points,and the specificity,sensitivity,and accuracy of ultrasonography were analyzed according to the thickness,structure,calcification,bone erosion,bursal thickness,and energy Doppler signals of the attachment points at different sites.Results Ultrasonography of the examined AS patients included abnormal attachment points with subjective symptoms(positive rate of 54%),mainly quadriceps tendon attachment points;abnormal attachment points without subjective symptoms but with pressure pain(positive rate of 46%),mainly plantar fascia attachment points;abnormal attachment points of the AS patients with subclinical attachment point inflammation(positive rate of 61%),mainly Achilles tendon attachment points.High-frequency ultrasound ultrasonography of different subclinical attachment point lesions had a higher detection rate of subclinical attachment point inflammation in AS patients compared with clinical examination(P<0.05).Compared with normal controls,high-frequency ultrasound had a high detection rate of subclinical attachment points,with tendon thickening and bursa thickening being the most common positive manifestations(P<0.05).Compared with clinical examination,high-frequency ultrasound had higher specificity,sensitivity,and accuracy in the early diagnosis of subclinical attachment points in different parts of AS.Conclusion Compared with unitary clinical examination,high-frequency ultrasound can effectively improve the detection rate and diagnostic value in the early diagnosis of subclinical attachment points in different parts of AS patients,making up for the underestimation of subclinical attachment point inflammation that clinical examination has always been.
high-frequency ultrasoundankylosing spondylitisattachment point inflammationsubclinical
万方数据
维普
