DOI: https://doi.org/10.22263/2312-4156.2016.5.71
Sirotka V.V.
The algorithm of ultrasound differential diagnosis of acute and chronic reactive arthritis course
Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
Vestnik VGMU. 2016;15(5):71-78.
Abstract.
Objectives. To develop the algorithm of ultrasound differential diagnosis of joint lesions in acute reactive arthritis (aReA) and chronic reactive arthritis (chReA).
Material and methods. The study involved 86 patients who were treated in Public Health Establishment «Vitebsk Regional Clinical Hospital»: 30 patients with aReA, 26 patients with chReA and 30 patients without any joint pathology - the control group (CG). All patients underwent comprehensive clinical-laboratory and instrumental examination as well as multiplane dynamic ultrasound investigation in B-mode with Doppler.
Results. It has been found that ultrasound criteria of joint damage in aReA are enthesitis, expressed synovitis, local osteitis and erosion of inflammation with a hypoechogenic contour under the affected enthesis, the absence of pathological vascularization in the synovium projection. Ultrasound criteria of chronic process (chReA) are: reduction of the affected enthesis thickness, the appearance in its projection of hyperechogenic inclusions (calcifications) of different localization – enthesophytes, osteophytes, «spurs»; the presence of formed inflammation erosion with a hyperechogenic contour under the affected enthesis. In all patients with ReA positive «pain test» under ultrasound control has been revealed.
Conclusions. An algorithm for differential diagnosis of acute and chronic course of reactive arthritis, the use of which will allow to adequately adjust the treatment in accordance with the activity and duration of the disease, has been developed.
Key words: algorithm, reactive arthritis, enthesitis, osteitis, erosion.
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Information about authors:
Sirotka V.V. – Candidate of Medical Sciences, associate professor of the Chair of Internal Medicine No. 1, Vitebsk State Order of Peoples’ Friendship Medical University.
Correspondence address: Republic of Belarus, 210023, Vitebsk, 27 Frunze ave., Vitebsk State Order of Peoples’ Friendship Medical University, Chair of Internal Medicine No.1. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. –Sirotka Volha V.
