J Rheumatol:强直性脊柱炎假关节的影像学和病理学研究

2018-09-27 MedSci MedSci原创

AS相关性假关节更可能起源于机械创伤,而不是炎症。

这项研究通过对手术中采集的标本进行病理分析,探讨强直性脊柱炎(AS)假关节的发病机制。

研究回顾性分析了17例伴假关节的连续性AS患者的影像学和临床数据。同时,还对手术中获得的标本进行了病理分析。

总共包括18个广泛的安德森病灶。在12名患者中发现了位于顶端区的假关节。分别在7个和6个病灶中观察到假关节上方或下方的完全骨化前纵韧带、后部或小关节骨折。所有病例中最明确的病理特征是增生的血管周围水肿性纤维组织,包括椎间盘、骨盘边界和椎体。发现了纤维蛋白样坏死、坏死骨碎片、含铁血黄素沉积和活动性软骨下骨生成,这提示了创伤过程。仅在2例中检测到轻度的血管周围炎性细胞集合。

AS相关性假关节更可能起源于机械创伤,而不是炎症。上述影像学和组织学研究结果表明,多种机制导致了假关节的形成。这些机制包括过度应力、不全骨折和涉及3柱结构的急性骨折。

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    2018-11-05 zywlvao
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    2018-09-29 jktdtl
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channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Sep 27 18:42:25 CST 2018, time=2018-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346954, encodeId=192c34695448, content=学习了长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Sep 27 18:42:21 CST 2018, time=2018-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346953, encodeId=02ef34695325, content=学习了长知识, 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encodeId=e2d534695161, content=学习了长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Sep 27 18:42:07 CST 2018, time=2018-09-27, status=1, ipAttribution=)]
    2018-09-27 Y—xianghai

    学习了长知识

    0

  5. 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encodeId=e2d534695161, content=学习了长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Sep 27 18:42:07 CST 2018, time=2018-09-27, status=1, ipAttribution=)]
    2018-09-27 Y—xianghai

    学习了长知识

    0

  6. 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    2018-09-27 Y—xianghai

    学习了长知识

    0

  7. 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encodeId=e2d534695161, content=学习了长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Sep 27 18:42:07 CST 2018, time=2018-09-27, status=1, ipAttribution=)]
    2018-09-27 Y—xianghai

    学习了长知识

    0

  8. 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channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Sep 27 18:42:25 CST 2018, time=2018-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346954, encodeId=192c34695448, content=学习了长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Sep 27 18:42:21 CST 2018, time=2018-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346953, encodeId=02ef34695325, content=学习了长知识, 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    2018-09-27 Y—xianghai

    学习了长知识

    0

  9. 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channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Sep 27 18:42:25 CST 2018, time=2018-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346954, encodeId=192c34695448, content=学习了长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Sep 27 18:42:21 CST 2018, time=2018-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346953, encodeId=02ef34695325, content=学习了长知识, 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encodeId=e2d534695161, content=学习了长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Sep 27 18:42:07 CST 2018, time=2018-09-27, status=1, ipAttribution=)]
    2018-09-27 Y—xianghai

    学习了长知识

    0

  10. 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encodeId=e2d534695161, content=学习了长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Sep 27 18:42:07 CST 2018, time=2018-09-27, status=1, ipAttribution=)]
    2018-09-27 Y—xianghai

    学习了长知识

    0

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男性和女性患者在TNF-α抑制剂治疗期间的临床改善相当。然而,2年后男性患者的影像学脊柱损伤更为明显。

脊柱关节炎与强直性脊柱炎的流行病学

脊柱关节炎(Spondyloarthritis,SpA)是指一类累及中轴和(或)外周关节的慢性炎症性疾病,具有明显的家族聚集倾向,SpA包括强直性脊柱炎(AnkylosingSpondylitis,AS)、反应性关节炎、银屑病关节炎等已有明确分类标准的疾病类型,但其最常见(>50%)的类型为未分化脊柱关节炎(UndifferentiatedSpondyloarthritis,uSpA),uSpA是

强直性脊柱炎患者需要警惕的致残杀手:髋关节受累

强直性脊柱炎常常被简称为"强直"、“强柱”或“强脊”,英文缩写为AS,有很多患者朋友自嘲为“小强”。该病主要发生于青壮年男性。以脊柱为主要病变的AS患者,对于日常生活的影响相对较小,然而,有一种类型的强直性脊柱炎,需要特别警惕,就是髋关节受累的AS,因为髋关节一旦受累,很有可能急速发展并导致残疾,追悔莫及!

Ann Rheum Dis:Risankizumab对强直性脊柱炎的疗效:随机双盲对照、概念验证、剂量寻找的2期试验结果

使用risankizumab治疗没有达到研究的主要终点,并且没有证据显示与安慰剂相比,对活动性AS患者risankizumab治疗可达到临床有意义的改善。