title: [Rheumatoid arthritis involving tibialis posterior tendon: study on the early diagnostic value of power Doppler ultrasonography and comparison with surgery].
abstract: Objective:To explore the value of power Doppler ultrasonography (PDUS) in the early diagnosis of tibialis posterior tendon injury induced by rheumatoid arthritis (RA).Method:From January 2014 to December 2015, a total of 48 cases (60 feet) of RA tendinopathy group were selected as the research subjects from Guanghua Hospital; 12 cases(20 feet) of non-RA tendinopathy group and 10 cases (20 feet) of healthy volunteers were selected as control group.The blood flow signals of pannus were observed by PDUS to determine whether the tendon was injured or the degree of the injury. The following indexes were compared and analyzed byChi-squaretesting: (1)positive rate of blood flow signal; (2)grade of blood flow signal; (3)spatial distribution of blood flow signal: diffusibility or local.Results:Of 70 cases(100 feet) in the study, the positive blood flow signals were only in the RA(88.3%) and non-RA group(40.0%) .Grade Ⅲ in RA was 20.0%, while this was not observed in non-RA . Grade Ⅱ in RA and non-RA was 36.7% and 10.0% , respectively. There were significant differences in the positive rate and grades between RA and non-RA group (P<0.01). The spatial distribution of blood flow signal in RA was significantly different from that in non-RA. In RA, they can be detected in the whole tendon.However, they were mainly distributed around the scaphoid in non-RA. In this study, three patients with grade Ⅲwere treated with surgery. The intraoperative findings were consistent with the preoperative ultrasound results.Conclusions:PDUS can be used to detect the neovascular formation of tendon synovitis. It can detect the early tendon injury before the appearance of foot deformity induced by RA, which can guide clinical early intervention treatment and prevent the occurrence of deformity and other serious consequences.
authors.affiliation: Department of Ultrasound, Guanghua Hospital of Integrated Traditional and Western Medicine, Shanghai 200052, China.
authors.forename: J Y
authors.initials: JY
authors.lastname: Mao
authors.forename: X H
authors.initials: XH
authors.lastname: Zhao
authors.forename: H
authors.initials: H
authors.lastname: Dai
authors.forename: X J
authors.initials: XJ
authors.lastname: Gao
authors.forename: L L
authors.initials: LL
authors.lastname: Lu
mesh_terms: D001172:Arthritis, Rheumatoid; D005528:Foot; D006801:Humans; D013710:Tendons; D018608:Ultrasonography, Doppler