Ultrasound detection of bone erosions in rheumatoid arthritis: a comparison to routine radiographs of the hands and feet.
ABSTRACT To determine if ultrasound (US) of selected joints in the hands and feet can detect more erosions than radiography and establish the presence of erosive disease in patients with rheumatoid arthritis (RA).
Eighty joints in ten patients with RA and 40 joints in five healthy control subjects, who were age, gender and ethnicity-matched to the patients with arthritis, were prospectively studied with radiographs and sonography. Conventional radiographs of the hands and feet were obtained. US examinations of the 2nd and 5th metacarpal-phalangeal (MCP) joints of the hands, and the 1st and 5th metatarsal-phalangeal (MTP) joints of the feet were performed. Radiographs and US exams were independently graded for the presence of erosions.
None of the control subjects had erosions. US detected erosions in 17/80, and radiographs detected erosions in 6/80 joints assessed with both modalities. US detected all erosions seen by radiographs in these selected joints. Erosive disease was present in the radiographs of seven of ten RA patients. US established erosive disease in eight of ten RA patients. US determined erosive disease in two of the three patients without radiographic erosions.
US of the MTP and MCP joints in RA can detect erosions not seen with radiography and may be complementary to radiography in establishing the presence of erosive disease in early RA.
- SourceAvailable from: scielo.br[Show abstract] [Hide abstract]
ABSTRACT: This review discusses the usefulness of ultrasound in the early diagnosis of reumathoid arthritis, its utilization in these patients treatment and its utility in evaluation of the response to treatment. Reumathoid arthritis is a chronic disease that when it is not promptly diagnosed it can cause physical deformity and disability to work. The early introduction of disease modifying antirheumatic drugs (DMARDs), no matter traditional or newer (biologic agents), may modify the disease outcome. In order that , the diagnosis of RA must be made as soon as possible. Ultrasound makes possible to study the joints and can show signs of inflammatory activity, especially synovitis. Color Doppler and power Doppler can help differentiate between active inflammatory tissue (pannus) and inactive inflammatory tissues. Erosions, tenossynovitis, bursitis, cysts and effusions can also be found. This article demonstrates that methods to quantify de inflammatory activity on ultrasound must yet be established.Revista Brasileira de Reumatologia 02/2008; 48(1):25-30. · 0.86 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: INTRODUCTION: Rheumatoid arthritis (RA) is a systemic inflammatory polyarthropathy characterized by progressive joint damage and non-articular complications such as osteoporosis (1) and associated with an increased risk of premature morbidity and mortality, predominantly due to increased cardiovascular disease (CVD) due to accelerated atherosclerosis (2) . The earliest appropriate initiation of treatment after disease onset offers the best chance of permanent remission and a normal lifespan so early diagnosis is essential (3) . Joint erosions identified by conventional radiography (CR) are late findings indicating a poor. prognosis (4) . More sensitive diagnostic tools for the early detection of joint damage include magnetic resonance imaging (MRI) and ultrasound (US) (5,6) . MRI provides excellent details for articular defects but it is expensive and less accessible to rheumatologists compared with US, which can be used at the bedside or in the clinic (7)01/2014;
- Revista Brasileira de Reumatologia 04/2007; 47(2):123-126. · 0.86 Impact Factor