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Суставы. Примечание. Э — счёт эрозий; С — счёт сужений

Стопы

1МФС(Э,С) 1-УПлФС(Э,С)

Примечание. Э — счёт эрозий; С — счёт сужений. При этом:

Таблица 26.

Счёт эрозий (Э)

0 баллов

1 балл

2-5(2-10) баллов

Отсутствие эрозий

Дефект поверхности кости

Более глубокий дефект или большее число дефектов поверхности кости

• Метод Ларсена-Дейла (табл. 27) С помощью этого метода описывают­ся пять степеней повреждения суста­вов кистей и стоп при РА. Существуют стандартные рентгенограммы степеней повреждения для каждого оценивае­мого сустава. Максимальный счёт в одном суставе составляет 5 баллов. При подсчете общего счёта суммируется количество баллов в каждом суставе, при этом количество баллов в суета-Таблица 27.

вах запястий умножается на 5. Макси­мальный общий счёт для одного паци­ента (индекс Ларсена—Дейла) состав­ляет 200 баллов.

EULAR" рекомендует использовать ме­тод Ларсена, когда изменения оценива­ются несколькими исследователями. Если оценку деструкции проводит один специалист, лучше применять модифици­рованный метод Шарпа (более чувстви­тельный).

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АНКИЛОЗИРУЮЩИЙ СПОНДИЛИТ (БОЛЕЗНЬ БЕХТЕРЕВА)

Анкилозирующий спондилит (АС) -хроническое системное воспалительное заболевание, характеризующееся пре­имущественным поражением крестцо-во-подвздошных сочленений и позво­ночника.

АС относится к группе серонегативных спондилоартритов, куда включены так­же реактивные артриты, псориатичес-кий артрит, спондилоартриты при неспе­цифическом язвенном колите и болезни Крона, а также недифференцированные спондилоартриты. Этим заболеваниям свойственны следующие общие черты: несимметричный олигоартрит преиму­щественно нижних конечностей, энтези-ты, сакроилиит и поражение других от­делов позвоночника, а также передний увеит, аортит, наследственная предрас­положенность, частое наличие HLA-B27 и отсутствие РФ в сыворотке крови. МКБ-10: М08.1 Юношеский анкилози­рующий спондилит; М45 Анкилозирую­щий спондилит; М48.1 Анкилозирую­щий гиперостоз Форестье. Аббревиатура. АС — анкилозирующий спондилит.

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