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류마티스관절염의 초음파 소견

Ultrasonographic Findings in Rheumatoid Arthritis

강태영
대한내과학회 (The Korean Association Of Internal Medicine)|2015.12|대한내과학회지 (The Korean Journal of Medicine)|제89권 제6호|pp. 609-615|DOI http://dx.doi.org/10.3904/kjm.2015.89.6.609

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키워드

Rheumatoid arthritis초음파Ultrasonography도플러Doppler류마티스관절염Synovitis활막염
주제분류내과학

초록

류마티스내과 근골격초음파(musculoskeletal ultrasound)는 류마티스내과 진료에서 그 유용성으로 인해 전 세계적으로 지난20여 년 동안 빠르게 성장해 왔으며, 류마티스내과 의사의진료의 일환으로 빠르게 통합되어 가고 있다. 초음파는 실시간(real time) 검사, 동적 검사(dynamic examination), 동시에여러 관절 검사 등 다른 영상기법들과 비교하여 여러 장점들을 가지고 있다. 초음파의 시술자 의존성(operator dependent) 의 단점도 표준화와 객관화를 통해 이제는 더 이상 장애물이 되지 않으며, 따라서 류마티스내과 진료에서 초음파의 활용 효용성에 대한 논란은 더 이상 무의미하다. 더욱이 초음파는 류마티스내과 의사가 관절염을 비롯한 류마티스질환의올바른 진단과 치료를 위해서는 반드시 갖추어야 할 진료의필수적인 도구가 되었다[1]. 최근에는 초음파의 영상학적인관절 관찰능력을 이용하여 류마티스관절염(rheumatoid arthritis, RA)의 조기진단, 활성도 평가 및 예후 판정에 활용되고 있다. 이 논문에서는 RA 환자에서 초음파 소견을 진단, 평가 및 예측의 논점으로 정리해 보고자 한다.

Abstract

Rheumatoid arthritis (RA) can be evaluated with ultrasound using both gray scale and Doppler mode. Gray scale provides cross-sectional images of joints, whereas Doppler shows the vascularity of the proliferated synovium. In RA, ultrasound can detect sub-clinical or early synovitis, assess arthritis more accurately than through clinical examination, and predict recurrence. In particular, a Doppler signal detected inside the joint cavity correlates with disease activity. Imaging remission can reflect the true remission status more accurately than with clinical remission. In this review, we focus on the use of ultrasonographic findings for the diagnosis, assessment, and prediction of RA.

참고문헌 (36)

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