Utility of power Doppler ultrasonography for detecting forefoot bursae in early rheumatoid arthritis A case report

被引：9

作者：

Endo, Yushiro ^{[1
]}

Koga, Tomohiro ^{[1
]}

Eguchi, Mizuna ^{[1
]}

Okamoto, Momoko ^{[1
]}

Tsuji, Sosuke ^{[1
]}

Takatani, Ayuko ^{[1
]}

Shimizu, Toshimasa ^{[1
]}

Sumiyoshi, Remi ^{[1
]}

Igawa, Takashi ^{[1
]}

Kawashiri, Shin-ya ^{[1
]}

Iwamoto, Naoki ^{[1
]}

Ichinose, Kunihiro ^{[1
]}

Tamai, Mami ^{[1
]}

Nakamura, Hideki ^{[1
]}

Origuchi, Tomoki ^{[1
]}

Kawakami, Atsushi ^{[1
]}

机构：

[1] Nagasaki Univ, Grad Sch Biomed Sci, Dept Immunol & Rheumatol, Unit Adv Prevent Med Sci, 1-7-1 Sakamoto, Nagasaki 8528501, Japan

来源：

MEDICINE | 2018年 / 97卷 / 51期

基金：

日本学术振兴会;

关键词：

forefoot bursitis; intermetatarsal bursitis; power Doppler ultrasonography; rheumatoid arthritis; ULTRASOUND; EROSIONS; JOINTS; METATARSOPHALANGEAL; TENOSYNOVITIS; PREVALENCE; DISABILITY; REVEALS; WRIST;

D O I：

10.1097/MD.0000000000013295

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Rationale: Power Doppler ultrasonography (PDUS) in musculoskeletal ultrasound (MSUS) is a sensitive and reliable method for the assessment of rheumatoid arthritis (RA). The association between ultrasound-detectable forefoot bursae and the development of RA has gained attention. However, a few studies have evaluated the utility of PDUS for examining forefoot bursae in early RA. We report the case of an RA patient who developed reduced foot mobility and had detectable intermetatarsal bursitis with remarkable power Doppler (PD) signals in MSUS at the onset of RA. Patient concerns: A 40-year-old Japanese woman diagnosed with palindromic rheumatism visited our department due to sustained forefoot pain and difficulty walking. The levels of both rheumatoid factor (RF) and anticitrullinated protein antibody (ACPA) were high. She had opening toes with swelling in metatarsophalangeal (MTP) joints. PDUS showed intermetatarsal bursitis with mild MTP synovitis. Diagnoses: We diagnosed RA by comprehensive judgment based on the 2010 American College of Rheumatology and European League Against Rheumatism classification criteria for RA. Interventions: We administered 6.0 mg/wk of methotrexate (MTN and 2.0 mg/d of prednisolone (PSL) followed by an increase of MTX to 10 mg/wk. Outcomes: After those treatments, the patient's symptoms showed improvement. As of this writing, the patient's remission has been maintained for >2 months.

引用

页数：4

共 31 条

[1]

Aletaha D, 2010, ANN RHEUM DIS, V69, P1580, DOI [10.1136/ard.2010.138461, 10.1002/art.27584]

[2] Practical US of the forefoot [J].