幼年特发性关节炎不同亚型的超声表型特征及其疾病活动度评估的差异化策略探索：一项横断面研究

牟芳婷; 邱敏; 尹春梅; 唐毅; 杨春江; 唐雪梅; 陈镜宇; 肖欢

doi:10.16016/j.2097-0927.202606012

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幼年特发性关节炎不同亚型的超声表型特征及其疾病活动度评估的差异化策略探索：一项横断面研究

临床医学 | 更新时间：2026-10-01

- 幼年特发性关节炎不同亚型的超声表型特征及其疾病活动度评估的差异化策略探索：一项横断面研究
- Ultrasonographic phenotypes of different juvenile idiopathic arthritis subtypes and differentiated strategies for disease activity assessment: a cross-sectional study
- 陆军军医大学学报 2026年48卷第18期页码：2633-2644
- 作者机构：
  
  1.重庆医科大学附属儿童医院超声科，儿童少年健康与疾病国家临床医学研究中心，儿童发育疾病研究教育部重点实验室，儿童代谢与炎症性疾病重庆市重点实验室，重庆
  3.重庆佑佑宝贝妇儿医院超声科，重庆
  2.重庆医科大学附属儿童医院风湿免疫科，重庆
- 作者简介：
  
  肖欢，E-mail： huan106689210@163.com
- 基金信息：
  
  重庆医科大学未来医学青年创新团队支持计划(W0114);重庆市自然科学基金（重庆市科学技术局）项目(CSTB2023NSCQ-MSX0660)
- DOI：10.16016/j.2097-0927.202606012
  中图分类号： R181.23;R445.2;R726.843
- 收稿：2026-06-02，
  
  修回：2026-08-04，
  
  录用：2026-08-06，
  
  纸质出版：2026-09-30
- 稿件说明：
移动端阅览
牟芳婷，邱敏，尹春梅，等.幼年特发性关节炎不同亚型的超声表型特征及其疾病活动度评估的差异化策略探索：一项横断面研究［J］.陆军军医大学学报，2026，48（18）：2633-2644.DOI：10.16016/j.2097-0927.202606012.

Mou F T，Qiu M，Yin C M，et al.Ultrasonographic phenotypes of different juvenile idiopathic arthritis subtypes and differentiated strategies for disease activity assessment： a cross-sectional study［J］.J Army Med Univ，2026，48（18）：2633-2644.DOI：10.16016/j.2097-0927.202606012.
牟芳婷，邱敏，尹春梅，等.幼年特发性关节炎不同亚型的超声表型特征及其疾病活动度评估的差异化策略探索：一项横断面研究［J］.陆军军医大学学报，2026，48（18）：2633-2644.DOI：10.16016/j.2097-0927.202606012. DOI：

Mou F T，Qiu M，Yin C M，et al.Ultrasonographic phenotypes of different juvenile idiopathic arthritis subtypes and differentiated strategies for disease activity assessment： a cross-sectional study［J］.J Army Med Univ，2026，48（18）：2633-2644.DOI：10.16016/j.2097-0927.202606012. DOI：

摘要

目的

幼年特发性关节炎（juvenile idiopathic arthritis，JIA）各亚型异质性显著，传统评估对亚临床滑膜炎识别不足。肌肉骨骼超声可敏感显示滑膜增厚、关节积液及异常血流信号，但不同亚型的超声表型特征尚缺乏系统比较。本研究旨在明确JIA不同亚型的特征性关节受累模式，为JIA的个体化超声评估提供依据。

方法

采用横断面研究设计方案，纳入重庆医科大学附属儿童医院2023年11月至2024年10月收治的261例JIA患儿（女135例，占51.7%；年龄中位数9.0岁，病程中位数为21.5个月），涵盖多关节型（pJIA，77例）、全身型（sJIA，67例）、少关节型（oJIA，48例）、附着点炎相关关节炎（ERA，36例）及未分类型（uJIA，33例）5种亚型。按标准化方案对68个外周关节行超声检查，依据国际风湿病结局评价定义及儿童关节炎与风湿病研究联盟半定量评分体系评估灰阶（grayscale，GS）及能量多普勒（power doppler，PD）超声信号。由2名对临床资料设盲的肌骨超声医师独立完成检查与评分；另从40例患儿中随机抽取GS、PD静态图像各75幅，由2名医师独立评分以评价观察者间一致性。疾病活动度采用JADAS27评分评估（活动期JADAS27

1）。在主体横断面研究中，以亚型及超声评分为分组/预测变量，以关节超声阳性率、GS/PD评分及JADAS27定义的疾病活动状态为结局指标。采用层次聚类分析受累模式，

检验筛选亚型间差异关节，Spearman相关分析评价超声评分与JADAS27的相关性，ROC曲线评价诊断效能。设置一个小样本（

=37）纵向随访评价治疗前后变化。

结果

①评分体系观察者间一致性优：GS评分ICC=0.87（95%

：0.78~0.95），PD评分ICC=0.85（95%

：0.78~0.91）。共评估17 748个关节，检出滑膜炎829个（4.7%），PD阳性525个（3.0%）。②各亚型呈可区分受累模式：多关节型（polyarticular JIA，pJIA）广泛关节受累［（6.2±10.0）个/例］，手部小关节突出（近端指间32.5%、掌指19.5%）；全身型（sJIA）以大关节为主［（3.1±4.3个/例）］，肩关节受累率19.4%，阳性者81.3%为sJIA；少关节型（oJIA）受累最少［（0.9±1.4个/例）］，以膝为主（18.8%）；附着点炎相关关节炎（enthesitis-related arthritis，ERA）为（1.5±1.3）个/例。肩、肘、腕、掌指、近端指间、远端指间关节亚型间差异有统计学意义（校正

0.05）。手-腕关节特征提示pJIA的AUC为0.61；肩关节阳性提示sJI

A特异度达0.99。③PD评分与JADAS27相关性（

=0.54，

0.001）强于GS评分（

=0.48，

0.001），pJIA中相关系数最高（

=0.71，

0.001）。PD评分对活动期判别效能中等（AUC=0.67，95%

：0.61~0.75，

0.001），最佳截断值≥1.0，敏感度51%、特异度82%；pJIA中AUC=0.73，sJIA与oJIA均为0.71，ERA中无统计学意义（

=0.33）。④纵向随访PD可反映治疗效果：平均4.4个月的纵向随访中，32例活动期患儿的JADAS27评分由8.0（4.0，15.3）分降至3.5（1.0，8.1）分（

0.001，SRM=-0.74）；PD评分由1.0（0，3.0）分降至0（0，1.0）分（

=0.003，SRM=-0.25），GS评分变化无统计学意义（

=0.67）。

结论

JIA不同亚型呈现可区分的超声表型特征：肩关节阳性高度指向sJIA，腕/MCP/PIP阳性倾向pJIA，oJIA与ERA几乎不累及肩及手部小关节。PD评分可敏感反映疾病活动度与治疗反应，但其诊断效能存在亚型差异：在pJIA中与疾病活动度相关性最强，而在sJIA与ERA中相对较弱，需结合全身炎症指标综合判断。

Abstract

Objective

Juvenile idiopathic arthritis (JIA) encompasses highly heterogeneous subtypes

and conventional clinical assessment often fails to detect subclinical synovitis. Musculoskeletal ultrasound can sensitively depict synovial hypertrophy

joint effusion and abnormal blood flow signals

yet the ultrasound phenotypes of different subtypes have not been systematically compared. This study aims to clarify the characteristic joint involvement patterns of different JIA subtypes

providing evidence for individualized ultrasonographic assessment in JIA.

Methods

A cross-sectional study was conducted on 261 children with JIA (135 girls

51.7%; median age 9.0 years; median disease duration 21.5 months) admitted to the Children's Hospital of Chongqing Medical University between November 2023 and October 2024

encompassing 5 subtypes: polyarticular JIA (pJIA

=77)

systemic JIA (sJIA

=67)

oligoarticular JIA (oJIA

=48)

enthesitis-related arthritis (ERA

=36)

and undifferentiated JIA (uJIA

=33). Ultrasonography was performed on

68 peripheral joints according to a standardized protocol. Grayscale (GS) synovitis and power Doppler (PD) signals were assessed using the Outcome Measures in Rheumatology definitions and the semiquantitative scoring system proposed by the Childhood Arthritis and Rheumatology Research Alliance. Examinations and scoring were independently completed by 2 musculoskeletal ultrasound physicians blinded to clinical data. Additionally

75 GS and 75 PD static images were randomly selected from 40 children for independent scoring by 2 physicians to evaluate interobserver agreement. Disease activity was evaluated using the JADAS27 score (active disease defined as JADAS27

1). In the main cross-sectional analysis

JIA subtype and ultrasound scores served as grouping/predictor variables

while joint-level ultrasound positivity rate

GS/PD scores

and disease activity state defined by JADAS27 served as outcome measures. Hierarchical clustering analysis was carried out to analyze involvement patterns

Chi

-square test to identify joints with significant differences across subtypes

Spearman correlation analysis to evaluate the correlations between ultrasound scores and JADAS27

and ROC curve analysis to assess diagnostic performance. A small-sample longitudinal follow-up subset (square test to identify joints with significant differences across subtypes

Spearman correlation analysis to evaluate the correlations between ultrasound scores and JADAS27

and ROC curve analysis to assess diagnostic performance. A small-sample longitudinal follow

=37) was included to evaluate the changes before and after treatment.

Results

①The interobserver agreement of the scoring system was excellent

with intraclass correlation coefficients of 0.87 (95%

: 0.78 to 0.95) for GS scores and 0.85 (95%

: 0.78 to 0.91) for PD scores. A total of 17 748 joints were evaluated

with synovitis detected in 829 joints (4.7%) and PD positivity in 525 joints (

3.0%). ②Distinct patterns of joint involvement were observed across subtypes: pJIA showed extensive polyarticular involvement (6.2±10.0 joints per case)

with prominent small-joint involvement in the hands (proximal interphalangeal 32.5%

metacarpophalangeal 19.5%); sJIA predominantly involved large joints (3.1±4.3 joints per case)

with shoulder involvement in 19.4% of patients (81.3% of those with shoulder involvement had sJIA); oJIA had the fewest involved joints (0.9±1.4 per case)

predominantly the knee (18.8%); ERA had a mean of 1.5±1.3 involved joints per case. Significant differences across subtypes were found in the shoulder

elbow

wrist

metacarpophalangeal

proximal interphalangeal

and distal interphalangeal joint (adjusted

0.05). The hand-wrist joint feature (positivity in wrist/MCP/PIP) yielded an AUC value of 0.61 for identifying pJIA; shoulder joint positivity showed a specificity of 0.99 for sJIA. PD scores were correlated more strongly with JADAS27 score (

=0.54

0.001) than GS scores (

=0.48

0.001)

with the highest correlation coefficient observed in pJIA (

=0.71

0.001). ③PD scores demonstrated moderate diagnostic performance for discriminating active disease (AUC=0.67

95%

: 0.61 to 0.75

0.001)

with an optimal cutoff of ≥1.0

a sensitivity of 51% and a specificity of 82%; the AUC value was 0.73 in pJIA

0.71 in both sJIA and oJIA

and not statistically significant in ERA (

=0.33). ④Longitudinal follow-up showed that PD scores could reflect treatment response. During a mean follow-up of 4.4 months in 32 patients with active disease at baseline

the JADAS27 score was decreased from 8.0 (4.0

15.3) to 3.5 (1.0

8.1) (

0.001

SRM=-0.74); PD scores were decreased from 1.0 (0

3.0) to 0 (0

1.0) (

=0.003

SRM=-0.25)

whereas GS scores showed no significant change

(

=0.67).

Conclusion

Distinct ultrasonographic phenotypes are identified across JIA subtypes: shoulder positivity strongly points to sJIA

wrist/MCP/PIP positivity tends to pJIA

while oJIA and ERA rarely involve the shoulder or small joints of the hands. The PD score can sensitively reflect disease activity and treatment response

but its diagnostic performance varies among subtypes: strongest correlation with disease activity in pJIA

whereas relatively weak in sJIA and ERA

requiring comprehensive assessment in considering systemic inflammatory indicators.

关键词

Keywords

references

Petty R ， Southwood T ， Manners P ， et al . International League of Associations for Rheumatology classification of juvenile idiopathic arthritis： second revision， Edmonton， 2001 ［J］. J Rheumatol ， 2004 ， 31 （ 2 ）： 390 - 392 .

Thierry S ， Fautrel B ， Lemelle I ， et al . Prevalence and incidence of juvenile idiopathic arthritis： a systematic review ［J］. Joint Bone Spine ， 2014 ； 81 （ 2 ）： 112 - 117 . DOI： 10.1016/j.jbspin.2013.09.003 http://dx.doi.org/10.1016/j.jbspin.2013.09.003 .

Ravelli A ， Consolaro A ， Horneff G ， et al . Treating juvenile idiopathic arthritis to target： recommendations of an international task force ［J］. Ann Rheum Dis ， 2018 ； 77 （ 6 ）： 819 - 828 . DOI： 10.1136/annrheumdis-2018-213030 http://dx.doi.org/10.1136/annrheumdis-2018-213030 .

Martini A ， Lovell D J ， Albani S ， et al . Juvenile idiopathic arthritis ［J］. Nat Rev Dis Primers ， 2022 ， 8 ： 5 . DOI： 10.1038/s41572-021-00332-8. DOI：10.1038/s41572-021-00332-8 http://dx.doi.org/10.1038/s41572-021-00332-8.DOI：10.1038/s41572-021-00332-8 .

Mehta S P ， Kendall K M ， Reasor C M . Virtual assessments of knee and wrist joint range motion have comparable reliability with face-to-face assessments ［J］. Musculoskeletal Care ， 2021 ； 19 （ 2 ）： 208 - 216 . DOI： 10.1002/msc.1525 http://dx.doi.org/10.1002/msc.1525 .

Consolaro A ， Giancane G ， Alongi A ， et al . Phenotypic variability and disparities in treatment and outcomes of childhood arthritis throughout the world： an observational cohort study ［J］. Lancet Child Adolesc Heal ， 2019 ， 3 （ 4 ）： 255 - 263 . DOI： 10.1016/S2352-4642（19）30027-6 http://dx.doi.org/10.1016/S2352-4642（19）30027-6 .

Magni-Manzoni S ， Epis O ， Ravelli A ， et al . Comparison of clinical versus ultrasound-determined synovitis in juvenile idiopathic arthritis ［J］. Arthritis Rheum ， 2009 ， 61 （ 11 ）： 1497 - 1504 . DOI： 10.1002/art.24823 http://dx.doi.org/10.1002/art.24823 .

Hemke R ， Herregods N ， Jaremko J L ， et al . Imaging of juvenile idiopathic arthritis ［J］. Radiologic Clin N Am ， 2024 ， 62 （ 5 ）： 889 - 902 . DOI： 10.1016/j.rcl.2024.02.009 http://dx.doi.org/10.1016/j.rcl.2024.02.009 .

Collado P ， Jousse-Joulin S ， Alcalde M ， et al . Is ultrasound a validated imaging tool for the diagnosis and management of synovitis in juvenile idiopathic arthritis？ A systematic literature review ［J］. Arthritis Care Res ， 2012 ， 64 （ 7 ）： 1011 - 1019 . DOI： 10.1002/acr.21644 http://dx.doi.org/10.1002/acr.21644 .

Collado P ， Naredo E ， Calvo C ， et al . Assessment of the joint recesses and tendon sheaths in healthy children by high-resolution B-mode and power Doppler sonography ［J］. Clin Exp Rheumatol ， 2007 ， 25 （ 6 ）： 915 - 921 .

Roth J ， Ravagnani V ， Backhaus M ， et al . Preliminary definitions for the sonographic features of synovitis in children ［J］. Arthritis Care Res ， 2017 ， 69 （ 8 ）： 1217 - 1223 . DOI： 10.1002/acr.23130 http://dx.doi.org/10.1002/acr.23130 .

Collado P ， Martire M V ， Lanni S ， et al . OMERACT International Consensus for Ultrasound Definitions of Tenosynovitis in Juvenile Idiopathic Arthritis： Systematic Literature Review and Delphi Process ［J］. Arthrit Care Res ， 2023 ， 75 （ 11 ）： 2277 - 2284 . DOI： 10.1002/acr.25159 http://dx.doi.org/10.1002/acr.25159 .

Rossi-Semerano L ， Breton S ， Semerano L ， et al . Application of the OMERACT synovitis ultrasound scoring system in juvenile idiopathic arthritis： a multicenter reliability exercise ［J］. Rheumatology （Oxford）， 2021 ， 60 （ 8 ）： 3579 - 3587 . DOI： 10.1093/rheumatology/keaa804 http://dx.doi.org/10.1093/rheumatology/keaa804 .

El Naggar T E ， Nasef S I ， Elshahaly M H ， et al . Role of musculoskeletal ultrasonography in the assessment of disease activity in juvenile idiopathic arthritis children ［J］. Egypt Rheumatologist ， 2024 ， 46 （ 3 ）： 125 - 129 . DOI： 10.1016/j.ejr.2024.04.004 http://dx.doi.org/10.1016/j.ejr.2024.04.004 .

Collado P ， Naredo E ， Calvo C ， et al . Reduced joint assessment vs comprehensive assessment for ultrasound detection of synovitis in juvenile idiopathic arthritis ［J］. Rheumatology ， 2013 ， 52 （ 8 ）： 1477 - 1484 . DOI： 10.1093/rheumatology/ket148 http://dx.doi.org/10.1093/rheumatology/ket148 .

Vega-Fernandez P ， Oberle E J ， Henrickson M ， et al . Musculoskeletal ultrasound and the assessment of disease activity in juvenile idiopathic arthritis ［J］. Arthritis Care Res ， 2023 ， 75 （ 8 ）： 1815 - 1820 . DOI： 10.1002/acr.25073 http://dx.doi.org/10.1002/acr.25073 .

Snipaitiene A ， Slegeryte A ， Uktveris R ， et al . The importance of ultrasound examination in care of juvenile idiopathic arthritis patients： 9 months follow-up study ［J］. Front Pediatr ， 2024 ， 12 ： 1414384 . DOI： 10.3389/fped.2024.1414384 http://dx.doi.org/10.3389/fped.2024.1414384 .

Shoop-Worrall S J W ， MacIntyre V G ， Ciurtin C ， et al . Overlap of international league of associations for rheumatology and preliminary pediatric rheumatology international trials organization classification criteria for nonsystemic juvenile idiopathic arthritis in an established UK multicentre inception cohort ［J］. Arthritis Care Res ， 2024 ， 76 （ 6 ）： 831 - 840 . DOI： 10.1002/acr.25296 http://dx.doi.org/10.1002/acr.25296 .

Grimes D A ， Schulz K F . An overview of clinical research： the lay of the land ［J］. Lancet ， 2002 ， 359 （ 9300 ）： 57 - 61 . DOI： 10.1016/S0140-6736（02）07283-5 http://dx.doi.org/10.1016/S0140-6736（02）07283-5 .

Consolaro A ， Ruperto N ， Bazso A ， et al . Development and validation of a composite disease activity score for juvenile idiopathic arthritis ［J］. Arthritis Rheum ， 2009 ， 61 （ 5 ）： 658 - 666 . DOI： 10.1002/art.24516 http://dx.doi.org/10.1002/art.24516 .

Vega-Fernandez P ， Ting T V ， Oberle E J ， et al . Musculoskeletal ultrasound in childhood arthritis limited examination： a comprehensive， reliable， time-efficient assessment of synovitis ［J］. Arthritis Care Res ， 2023 ， 75 （ 2 ）： 401 - 409 . DOI： 10.1002/acr.24759 http://dx.doi.org/10.1002/acr.24759 .

Sande N K ， Bøyesen P ， Aga A B ， et al . Development and reliability of a novel ultrasonographic joint-specific scoring system for synovitis with reference atlas for patients with juvenile idiopathic arthritis ［J］. RMD Open ， 2021 ， 7 （ 2 ）： e001581 . DOI： 10.1136/rmdopen-2021-001581 http://dx.doi.org/10.1136/rmdopen-2021-001581 .

Koo T K ， Li M Y . A guideline of selecting and reporting intraclass correlation coefficients for reliability research ［J］. J Chiropr Med ， 2016 ， 15 （ 2 ）： 155 - 163 . DOI： 10.1016/j.jcm.2016.02.012 http://dx.doi.org/10.1016/j.jcm.2016.02.012 .

Sande N K ， Kirkhus E ， Lilleby V ， et al . Validity of an ultrasonographic joint-specific scoring system in juvenile idiopathic arthritis： a cross-sectional study comparing ultrasound findings of synovitis with whole-body magnetic resonance imaging and clinical assessment ［J］. RMD Open ， 2024 ， 10 （ 1 ）： e003965 . DOI： 10.1136/rmdopen-2023-003965 http://dx.doi.org/10.1136/rmdopen-2023-003965 .

Borocco C ， Anselmi F ， Rossi-Semerano L . Contribution of ultrasound in current practice for managing juvenile idiopathic arthritis ［J］. J Clin Med ， 2022 ， 12 （ 1 ）： 91 . DOI： 10.3390/jcm12010091 http://dx.doi.org/10.3390/jcm12010091 .

Eng S W M ， Aeschlimann F A ， van Veenendaal M ， et al . Patterns of joint involvement in juvenile idiopathic arthritis and prediction of disease course： a prospective study with multilayer non-negative matrix factorization ［J］. PLoS Med ， 2019 ， 16 （ 2 ）： e1002750 . DOI： 10.1371/journal.pmed.1002750 http://dx.doi.org/10.1371/journal.pmed.1002750 .

Walther M ， Harms H ， Krenn V ， et al . Correlation of power Doppler sonography with vascularity of the synovial tissue of the knee joint in patients with osteoarthritis and rheumatoid arthritis ［J］. Arthritis Rheum ， 2001 ， 44 （ 2 ）： 331 - 338 . DOI： 10.1002/1529-0131（200102）44： 2<331：： aid-anr50>3.0.co；2-0 http://dx.doi.org/10.1002/1529-0131（200102）44：2<331：：aid-anr50>3.0.co；2-0 .

Walther M ， Harms H ， Krenn V ， et al . Synovial tissue of the hip at power Doppler US： correlation between vascularity and power Doppler US signal ［J］. Radiology ， 2002 ， 225 （ 1 ）： 225 - 231 . DOI： 10.1148/radiol.2251011272 http://dx.doi.org/10.1148/radiol.2251011272 .

Naredo E ， Bonilla G ， Gamero F ， et al . Assessment of inflammatory activity in rheumatoid arthritis： a comparative study of clinical evaluation with grey scale and power Doppler ultrasonography ［J］. Ann Rheum Dis ， 2005 ， 64 （ 3 ）： 375 - 381 . DOI： 10.1136/ard.2004.023929 http://dx.doi.org/10.1136/ard.2004.023929 .

Macaubas C ， Nguyen K ， Milojevic D ， et al . Oligoarticular and polyarticular JIA： epidemiology and pathogenesis ［J］. Nat Rev Rheumatol ， 2009 ， 5 （ 11 ）： 616 - 626 . DOI： 10.1038/nrrheum.2009.209 http://dx.doi.org/10.1038/nrrheum.2009.209 .

Kessel C ， Hedrich C M ， Foell D . Innately adaptive or truly autoimmune： is there something unique about systemic juvenile idiopathic arthritis？［J］. Arthritis Rheumatol ， 2020 ， 72 （ 2 ）： 210 - 219 . DOI： 10.1002/art.41107 http://dx.doi.org/10.1002/art.41107 .

Rosina S ， Rebollo-Giménez A I ， Tarantola L ， et al . Defining criteria for disease activity states in systemic juvenile idiopathic arthritis based on the systemic juvenile arthritis disease activity score ［J］. Arthritis Rheumatol ， 2024 ， 76 （ 9 ）： 1446 - 1454 . DOI： 10.1002/art.42865 http://dx.doi.org/10.1002/art.42865 .

Miotto E Silva V B ， Mitraud S A V ， Furtado R N V ， et al . Patients with juvenile idiopathic arthritis in clinical remission with positive power Doppler signal in joint ultrasonography have an increased rate of clinical flare： a prospective study ［J］. Pediatr Rheumatol Online J ， 2017 ， 15 （ 1 ）： 80 . DOI： 10.1186/s12969-017-0208-7 http://dx.doi.org/10.1186/s12969-017-0208-7 .

de Lucia O ， Ravagnani V ， Pregnolato F ， et al . Baseline ultrasound examination as possible predictor of relapse in patients affected by juvenile idiopathic arthritis （JIA）［J］. Ann Rheum Dis ， 2018 ， 77 （ 10 ）： 1426 - 1431 . DOI： 10.1136/annrheumdis-2017-211696 http://dx.doi.org/10.1136/annrheumdis-2017-211696 .

Gmuca S ， Xiao R ， Brandon T G ， et al . Multicenter inception cohort of enthesitis-related arthritis： variation in disease characteristics and treatment approaches ［J］. Arthritis Res Ther ， 2017 ， 19 （ 1 ）： 84 . DOI： 10.1186/s13075-017-1297-x http://dx.doi.org/10.1186/s13075-017-1297-x .

Hahn Y S . Enthesitis-related arthritis ［J］. J Rheum Dis ， 2018 ， 25 （ 4 ）： 221 . DOI： 10.4078/jrd.2018.25.4.221 http://dx.doi.org/10.4078/jrd.2018.25.4.221 .

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