肩関節
Online ISSN : 1881-6363
Print ISSN : 0910-4461
ISSN-L : 0910-4461
慢性関節リウマチにおける肩鎖関節の超音波検査
高田 直也種田 陽一後藤 英之松井 宣夫杉本 勝正大藪 直子中野 幸雄
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ジャーナル フリー

1997 年 21 巻 3 号 p. 565-568

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(Purpose) Functional impairment of the shoulder joint is often seen in patients with rheumatoid arthritis (RA), but complaints concerning the acromioclavicular (AC) joint are rare. Still, various changes are observed including joint effusion, synovial proliferation and cartilage destruction. The purpose of this study is to evaluate the changes of the AC joint by ultrasonography and radiography.
(Materials and methods) Twelve AC joints of 6 cadavers without RA,2 males and 4 females with a mean age of 85.0 years, were evaluated by ultrasonography and anatomized. Sixty shoulders of 30 patients with RA who visited our institution were evaluated by ultrasonography and radiography. There were 5 males and 25 females with a mean age of 60.0 years (range 28 to 72 years), and with a mean disease duration of 18.0 years (range 1 to 43 years). Changes of the AC joint (narrowing of the joint space, erosion, osteolysis and tapering) were studied by ultrasonograms and radiograms.
(Results) In the anatomical observation of cadavers there were 10 shoulders with no change in the AC joint. Narrowing of the AC joint was found in 2 shoulders. Swelling of the AC joint was found in 2shoulders. These findings were confirmed by ultrasonography. On ultrasonograms, there were 11 shoulders with no change in the AC joint. These 11 joints ranged from stage 0 to III radiographically. Narrowing of the AC joint was found in 9 shoulders, AC joints with wide cranial sides and narrow caudal sides were found in 21 shoulders. Most of these 30 shoulders were stage II radiographically. Widening of the AC joint with erosion of the joint surfaces was found in 13 shoulders, most of which were stage II and N. A wide gap between the osteolytic distal end of the clavicle and the acromion was found in 6 shoulders. Swelling and effusion of the AC joint was found in 13 shoulders. As for radiography, changes of the AC joint including narrowing of the joint space, erosion, osteolysis and tapering could be confirmed by ultrasonography. In addition, swelling and effusion of the AC joint could be detected by ultrasonography. Ultrasonography can be useful in evaluating the condition of the AC joint in RA.

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© 日本肩関節学会
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