译者：王小静校对：高晋芳审核：
摘要：介绍：本研究旨在探讨无症状高尿酸血症患者透明软骨、关节腔、肌腱部位超声下出现哪些病理改变预示患者会进展为痛风。方法：该研究为一项横断面研究，对所有入组者行双膝、双足第一跖趾关节（MTP1）、肌腱及双下肢附着点超声检查。根据情况采用χ2检验比较差异性或采用非配对t检验进行估计。相关性采用Spearmans相关系数测试。结果：研究纳入50例无症状高尿酸血症患者、52例血尿酸水平正常的受试者。无症状高尿酸血症组25%的患者双足第一跖趾关节检测到“双轨征”，相比之下，对照组患者没有检测到“双轨征”（P0.）。无症状高尿酸血症组17％的患者双膝关节软骨检测到“双轨征”，对照组未检测到双轨征（P0.）。另外，无症状高尿酸血症组髌骨末端病、痛风石以及跟腱末端病发生率高于对照组（分别为12％vs2.9％P=0.01,6％vs0P=0.01,15％vs1.9％，P=0.）。无症状高尿酸血症组有8例患者关节腔内发现痛风石，对照组未发现（P=0.）。结论：研究表明，无症状高尿酸血症患者关节内及关节外结构发生改变预示着痛风性关节炎的发生。
Abstract:INTRODUCTION:Inthisstudy,weaimedtoinvestigateultrasonographic(US)changessuggestiveofgoutyarthritisinthehyalinecartilage,jointsandtendonsfromasymptomaticindividualswithhyperuricemia.METHODS:Weconductedacross-sectional,controlledstudyincludingUSexaminationsofthekneesandfirstmetatarsal-phalangealjoints(firstMTPJs),aswellasofthetendonsandenthesisofthelowerlimbs.Differenceswereestimatedbyχ2orunpairedt-testsasappropriate.AssociationswerecalculatedusingtheSpearmanscorrelationcoefficientranktest.RESULTS:Fiftyasymptomaticindividualswithhyperuricemiaand52normouricemicsubjectswereincluded.Hyperechoicenhancementofthesuperficialmarginofthehyalinecartilage(doublecontoursign)wasfoundin25%ofthefirstMTPJsfromhyperuricemicindividuals,incontrasttononeinthecontrolgroup(P0.).Similarresultswerefoundonthefemoralcartilage(17%versus0;P0.).Patellarenthesopathy(12%versus2.9%;P=0.01)andtophi(6%versus0;P=0.01)aswellasAchillesenthesopathy(15%versus1.9%;P=0.)weremorefrequentinhyperuricemicthaninnormouricemicindividuals.Intra-articulartophiwerefoundineighthyperuricemicindividualsbutinnoneofthenormouricemicsubjects(P=0.).CONCLUSIONS:Thesedatademonstratethatmorphostructuralchangessuggestiveofgoutyarthritisinducedbychronichyperuricemiafrequentlyoccurinbothintra-andextra-articularstructuresofclinicallyasymptomaticindividuals.
引自：PinedaC,Amezcua-GuerraLM,SolanoCetal.Jointandtendonsubclinicalinvolvementsuggestiveofgoutyarthritisinasymptomatichyperuricemia:anultrasoundcontrolledstudy.ArthritisResTher.Jan17;13(1):R4
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