EVALUATION OF HAND AND WRIST JOINTS USING ULTRASONOGRAPHY AND DOPPLER IN PATIENTS OF RHEUMATOID ARTHRITIS: COMPARISON WITH CONVENTIONAL RADIOGRAPHY AND CLINICAL CORRELATION

Abstract

Background- Ultrasound (US) together with power Doppler (PD) are progressively being employed to assess joint involvement in rheumatoid arthritis (RA). High-resolution US permits direct assessment of intra-articular and periarticular inammatory activity and structural damage in inammatory arthritis. To analyze the quality of point-of-care hand and wrist ultra Objective- sound (US) examination in patients with established rheumatoid arthritis, it's comparison with standard radiography and clinical correlation. This prospective study was performed in 32 Methodspatients. Gray scale and power doppler ultrasonography of bilateral hand and wrist joint were performed employing a high-frequency linear transducer. Various ndings were recorded together with synovial hypertrophy, Power Doppler abnormality, soft tissue thickening, tendonitis, joint effusion, periosteal reaction, and erosions. Composite ultrasound scores and Disease Activity Score 28 were calculated and compared. ResultsUltrasound detected a lot of abnormalities within hand joints than the clinical examination. Synovial hypertrophy was detected altogether in 24 (75%) patients on gray scale ultrasound, active synovitis detected by using Doppler US in 20 patients (62.5%), effusion was detected in 10 patients (37.5 %), bone erosions (mostly in DIP and PIP joints) were detected in 20 patients (62.5%) and X-ray nding was detected in 8 patients (25%). There was a positive correlation of Power Doppler with synovial hypertrophy, bone erosions, Erythrocyte Sedimentation Rate and Disease Activity Score. Ultrasound could be a helpful reliable modality for the target assess Conclusion- ment of both soft tissue and erosive joint changes occurring in early stage in rheumatoid arthritis. Power doppler scores can be applied with bigger accuracy than clinical scores of synovitis in rheumatologic practice to enable therapeutic choices and to evaluate disease outcome and response to treatment.