发生在关节的“海鸥翼征”

海鸥翼征

【英文】Gull Wing Appearance

【影像表现】

海鸥翼征见于侵蚀性骨关节炎手足指（趾）间关节，表现为关节面中央部分的新生骨和边缘关节面下的骨侵蚀构成的影像，类似一只展翅的海鸥而得名。见图1。

【病理基础】

指（趾）间关节软骨面因为滑膜炎侵蚀而有一定程度的破坏，由关节面边缘逐渐扩展到中央部，同时伴有骨膜性成骨。

【鉴别诊断】

海鸥翼征的出现并不代表有特异性，它是外周侵蚀性骨关节炎的一种表现，银屑性关节炎、强直性脊柱炎等均可出现该征象。

图1鸥翼征X线图像

银屑病关节炎病人的拇指：双侧指间关节均有严重关节炎（Ⅲ级），注意远端指骨关节面的“鸥翼”外观，中央边缘毛糙的新生骨形成伴两侧关节面的侵蚀，同时伴有周围软组织肿胀

来源：放射学征象

扩展阅读

对应疾病：侵蚀性骨关节炎

Corresponding diseases: erosive osteoarthritis

骨关节炎是一种以关节软骨的变性，破坏骨质增生为特征的慢性关节病。

Osteoarthritis is a chronic joint disease characterized by degeneration of articular cartilage and destruction of osteogenic hyperplasia.

本病在中年以后多发，研究表明，骨关节炎在40岁人群的患病率为10%-17%，60岁以上则达到50%，而在75岁以上人群中80%患有骨关节炎，该病的最终致残率为53%。

This disease occurs frequently after middle age. Studies show that the prevalence rate of osteoarthritis in people aged 40 is 10 to 17 percent, 50 percent over 60 years old, and 80 percent of people over 75 years old have osteoarthritis, with the ultimate disability rate of 53 percent.

临床表现以关节疼痛、骨质增生及活动受限最为常见，骨关节炎的发病无地区及种族差异。

The clinical manifestations of osteoarthritis were joint pain, hyperosteogeny and activity limitation.

骨关节炎主要表现为受累关节的疼痛，肿胀、晨僵、关节积液及骨性肥大。可伴有活动时的骨摩擦音、功能障碍或畸形。

Osteoarthritis is mainly manifested as pain of the affected joints, swelling, morning stiffness, joint effusion and bone hypertrophy. May accompany when the bone friction sound, the function obstacle or the deformity.

年龄、肥胖、炎症、创伤及遗传因素等可能与本病的发生有关。

Age, obesity, inflammation, trauma and genetic factors may be associated with the occurrence of the disease.

手：以远端指间关节受累最为常见，表现为关节伸侧面的两侧骨性膨大，称赫伯登结节。而近端指间关节伸侧出现者称为布夏尔结节。

Hand: distal interphalangeal joint involvement is most common, presenting as bilateral bony enlargement of the extension side of the joint, known as the herberden nodule. The extensional proximal interphalangeal joint is known as the burshire tubercle.

可伴有结节局部的轻度红肿、疼痛和压痛，第一腕掌关节受累后，其基底部的骨质增生可出现方形手畸形，而手指关节增生及侧向半脱位可致蛇样畸形。

It can be accompanied by mild redness, pain and tenderness in the local nodules. After the first carpal palmar joint is involved, the bone hyperplasia in its basal part may lead to square hand deformity, while the hyperplasia of finger joints and lateral hemidislocation may lead to serpentine deformity.

常见于绝经后的女性，主要累及远端及近端指间关节和腕掌关节，有家族倾向性及反复急性发作的特点。受累的关节出现疼痛和触痛，可最终导致关节的畸形和强直。

It is common in postmenopausal women, mainly involving the distal and proximal interphalangeal and carpal joints, and has the characteristics of family orientation and repeated acute attacks. Pain and tenderness in the affected joint can eventually lead to deformity and stiffness of the joint.

患者的滑膜检查可见明显的增生性滑膜炎，并可见免疫复合物的沉积和血管的生成。

The patient's synovial examination showed obvious proliferative synovitis, and showed the deposition of immune compounds and the formation of blood vessels.

X线可见明显的骨赘生成和软骨下骨硬化，晚期可见明显的骨侵蚀和关节骨性强直。

X - ray showed obvious osteophyte formation and subchondral osteosclerosis.