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目的:总结类风湿关节炎(RA)患者拇长屈肌腱(FHL)病变的超声特点及二者间的相关性。方法:回顾性分析2010年2月至2011年6月因足部疼痛于我院就诊的60例(120足)RA患者资料。应用彩色多普勒超声诊断仪探查拇长屈肌腱,根据超声探查拇长屈肌腱病变情况的结果将患者分为3组:肌腱完整组(A组,45足),肌腱周围炎症组(B组,49足),肌腱断裂组(C组,26足)。对拇长屈肌腱病变的特点及部位进行描述,并将拇长屈肌腱病变严重程度与患者年龄及病程进行相关性分析。结果:45足肌腱完整,49足出现不同部位的肌腱周围炎症(内踝转折处17足,henrry’s结节处11足,第一跖趾关节跖侧21足),26足发生肌腱断裂(9足发生于内踝转折处,17足发生于跖趾关节跖侧)。肌腱病变的发生率71%。A组平均年龄49.9±9.2岁,病程4.7±2.6年;B组平均年龄56.2±9.2岁,病程16.2±7.4年;C组平均年龄54.7±8.0岁,病程20.9±4.4年。三组间上述参数差异具有统计学意义(P<0.05)。结论:拇长屈肌腱是类风湿关节炎足部结构的常见受累部位,其病变多发生于内踝转折处,henrry’s结节处及第一跖趾关节跖侧,但henrry’s结节处的断裂少见。在对类风湿关节炎平足患者进行肌腱转位手术时,应充分考量拇长屈肌腱的病变。
Objective: To summarize the ultrasonic features and the correlation between the two in rheumatoid arthritis (RA) patients. Methods: A retrospective analysis of 60 patients (120 feet) of RA patients with foot pain in our hospital from February 2010 to June 2011 was retrospectively analyzed. The flexor pollicis tendus was examined by color Doppler sonography. The patients were divided into 3 groups according to the results of ultrasonic examination of the lesion of flexor hallucis longus: group A (45 feet), group B , 49 feet), tendon rupture group (C group, 26 feet). The characteristics and location of flexor tendon flexor tendon were described, and the severity of flexor hallucis longus tendinopathy was analyzed with the patient’s age and duration. Results: Forty-five foot tendons were intact, and 49 feet showed inflammation around the tendons in different sites (17 feet at the medial malleolus, 11 feet at henry’s nodules and 21 feet at the first metatarsophalangeal joint plantar), and 26 feet had tendon rupture At the medial malleolus, 17 feet occurred at the metatarsophalangeal joint plantar side). The incidence of tendinous lesions 71%. The average age of group A was 49.9 ± 9.2 years and the duration of disease was 4.7 ± 2.6 years. The average age of group B was 56.2 ± 9.2 years and the duration of disease was 16.2 ± 7.4 years. The average age of group C was 54.7 ± 8.0 years and the duration was 20.9 ± 4.4 years. The differences among the three groups were statistically significant (P <0.05). Conclusion: The flexor hallucis longus tendon is a common site of the foot structure of rheumatoid arthritis. The lesions mostly occur at the medial malleolus, henry’s nodules and the first metatarsophalangeal joints. However, the henrry’s nodules are rare. In patients with rheumatoid arthritis flat foot tendon transposition surgery, should take full account of the thumb flexor tendon lesions.