臨床整形外科57巻7号

2022年07月発行

特集 整形外科医×関節リウマチ診療　今後の関わり方を考える

関節リウマチ診断における筋骨格超音波検査と関節液検査の使い方

著者： 三好雄二¹ 横川直人¹

所属機関： ¹東京都立多摩総合医療センターリウマチ膠原病科

ページ範囲：P.883 - P.890

関節炎の正確な診断が関節リウマチ(RA)診療には不可欠である．筋骨格超音波検査(MSUS)と関節液検査は炎症性関節炎の有用な補助検査である．MSUSの滑膜炎所見は検査者間一致率が高く，身体診察よりも感度が高い．Subclinicalな滑膜炎を検出することでより精度の高いRA診断ができる．RAの重要な鑑別診断である結晶誘発性関節炎のゴールドスタンダードは関節液の鏡検である．令和4年度診療報酬改定で偏光顕微鏡を用いた関節液検査が保険収載された．関節液の結晶検査が本邦で広く利用されることが望まれる．

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