Ультразвуковое исследование суставов при ревматоидном артрите: патогенетическая обоснованность, возможности использования в диагностике, оценке эффективности терапии и прогнозировании исходов

Ревматоидный артрит (РА) – аутоиммунное ревматическое заболевание, характеризующееся хроническим эрозивным артритом и системными воспалительными изменениями внутренних органов, приводящими к ранней инвалидизации и ухудшению качества жизни пациентов. Современные методы визуализации явились новым этапом не только в диагностике заболеваний, но и в оценке течения и прогнозировании исходов. Ультразвуковое исследование суставов при РА на данный момент рассматривается как один из доступных и широко используемых методов инструментального исследования. В настоящем обзоре зарубежной литературы проводится подробный анализ публикаций, посвященных ультразвуковому исследованию суставов при РА. Их результаты противоречивы и зачастую ставят под сомнение информативность данного метода. Многочисленность оригинальных публикаций свидетельствует о большом интересе ревматологов к этому методу. Приведены существующие на настоящий момент точки зрения на патогенетическую обоснованность, диагностическую значимость и прогностический потенциал использования ультразвука у пациентов с РА. Обсуждаются вопросы методологии диагностической процедуры, необходимости использования энергетического допплеровского картирования, а также современные полуколичественные шкалы оценки выраженности воспаления. Представлены существующие зарубежные рекомендации для использования ультразвука при РА, подтверждающие важность этого метода визуализации.

ревматоидный артрит, энергетический допплер, «серая» шкала, рентгенологическое прогрессирование

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