Saigal, et al.: US evaluation in rheumatoid arthritis
Indian Journal of Rheumatology ¦ Volume 12 ¦ Issue 1 ¦ March 2017 10
making it suitable as a potenal maker of disease acvity
and a tool for grading disease severity.
Naredo et a1. also highlighted the beer correlaon of
US ndings with CRP and ESR than clinical assessment.
Overall, US was found to be a more reliable technique to
detects bore erosions than radiography in early RA.
US has several limitaons also, for example, it is considered
to be an operator-dependent technology with poor
repeatability; deeper structures are dicult to visualize as the
higher frequency transducers have lower ssue penetraon,
and negave PD ow cannot exclude an acve synovis.
In present study also two paents with low disease acvity
had zero CFS. Another limitaon of US is its inability to
detect bone marrow edema which is a predictor of future
development of erosions and is easily detected on MRI.
Our study had certain limitaons. First, Intraobserver
variability assessment was not done in this study. Second,
as this was an observaonal study and healthy controls
were not taken for comparison of US and X-ray ndings.
In our small study we found that US was more sensive
than CR for detecon of erosions. US including PDUS
and gray scale imaging detected CFS (an indicator of
ongoing inammaon) in clinically quiescent RA. US
reliably predicted disease severity and had a signicant
correlaon with other validated markers of disease acvity.
Ultrasound therefore appears to be a useful adjunct in the
management of paents with RA.
The authors are thankful to Dr. Meenu Bagarhaa
(Department of Radiodiagnosis, SMS Medical College,
Jaipur) for her inputs in wring of this manuscript.
Financial support and sponsorship
Conicts of interest
There are no conicts of interest.
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