| 特集名 | アミロイド骨・関節症 -- 診断と治療の実際 | |
|---|---|---|
| 題名 | 診断 (3) 超音波診断 | |
| 発刊年月 | 1997年 08月 | |
| 著者 | 青柳 竜治 | 小千谷総合病院内科 |
| 著者 | 荒川 正昭 | 新潟大学医学部第二内科 |
| 【 要旨 】 | 透析アミロイド症の確定診断には，生検による組織学的検査が必須である．肩および股関節の超音波検査では，関節周囲の軟部組織(関節包，靱帯，関節液貯留など)の描出が可能である．最近では，肩および股関節の超音波検査が透析アミロイド骨・関節症の補助的診断法として応用されている． 筆者らは，関節包膨隆度の指標としてshou1der-capsular distance(SCD)とhip-capsular distance(HCD)を計測した． 透析アミロイド骨・関節症合併例では非合併例に比べSCDおよびHCDが増加していた．また，経時的観察では，関節包膨隆度は増加した． 関節超音波検査は，非侵襲的であり繰り返し行うことが可能である．また，透析アミロイド骨・関節症の補助的診断法としても有用な検査である． |
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| Theme | Amyloid-Related Bone and Joint Derangements -- Clinical Diagnosis and Treatment | |
|---|---|---|
| Title | Ultrasonographic evaluation of dialysis-related osteoarthropathy | |
| Author | Ryuji Aoyagi | Division of Internal Medicine, Ojiya General Hospital |
| Author | Masaaki Arakawa | Department of Medicine (II), Niigata University School of Medicine |
| [ Summary ] | The diagnosis of dialysis-related amyloidosis is confirmed by histologic evaluation of the involved tissue. Ultrasonographic images of shoulder and hip joints clearly demonstrate periarticular soft tissue structures such as the joint capsule, Iigament, and fluid collection. Recently, ultrasonography of shoulder and hip joints has facilitated the diagnosis of dialysis-related amyloidosis. We measured the distance between the humeral surface and the inner surface of the deltoid muscle (shoulder-capsular distance ; SCD), and the femoral surface and the hip joint capsule (hip-capsular distance : HCD), as markers of joint capsule swelling. The SCD and HCD were significantly wider in patients with than in those without dialysis-related amyloid osteoarthropathy. In longitudinal study revealed these parameters to be increased. Ultrasonography of shoulder and hip joints is a useful and non-invasive tool for evaluating dialysis arthropathy, and also facilitates the diagnosis and monitoring of dialysis-related amyloid osteoarthropathy. |
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