Ultrasonography in Early Rheumatoid Arthritis of Hand and Wrist Joints: Comparison with Magnetic Resonance Imaging.
Early disease
Erosions
Magnetic resonance imaging
Rheumatoid arthritis
Synovitis
Tenosynovitis
Ultrasonography
Journal
Indian journal of orthopaedics
ISSN: 0019-5413
Titre abrégé: Indian J Orthop
Pays: Switzerland
ID NLM: 0137736
Informations de publication
Date de publication:
Sep 2020
Sep 2020
Historique:
received:
27
12
2019
accepted:
19
06
2020
entrez:
28
8
2020
pubmed:
28
8
2020
medline:
28
8
2020
Statut:
epublish
Résumé
The aim of the study was to evaluate the use of ultrasonography (USG) including power Doppler in detecting hand and wrist joint changes in early rheumatoid arthritis (RA) and to compare USG findings with magnetic resonance imaging (MRI). Thirty-four patients diagnosed as RA by 2010 ACR/EULAR criteria; with the onset of symptoms within last one year, were included in the study after institute ethical clearance and informed consent to undergo USG and contrast-enhanced MRI of the dominant affected hand. Second to fifth metacarpophalangeal (MCP) joints, second to fifth proximal interphalangeal (PIP) joints and wrist joints (total nine joints) were evaluated for synovitis, erosions along with tenosynovitis. USG and MRI features were compared; agreement on the two imaging modalities as well as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of ultrasonography compared to MRI (gold standard) was calculated. One hundred thirty-six MCP, 136 PIP and 34 wrist joints (total 306 joints) and 136 flexor tendons were evaluated. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of USG for diagnosing synovitis was 78.6%, 91.1%, 86.1%, 85.8%, 86.3%; for erosions 67.2%, 97.5%, 84.8%, 90.5%, 91.5%; for tenosynovitis 86.5%, 100%, 100%, 92.3% and 94.8% respectively. The overall agreement between USG and MRI for detection of synovitis was achieved in 83% joints and for erosions in 89.5% joints. In early RA, USG was nearly as effective in diagnosing features of joint and tendon sheath involvement, with relatively better performance of USG for tenosynovitis. The performance of USG in diagnosing erosions was limited likely due to difficult access of three-dimensional joint structure.
Sections du résumé
BACKGROUND
BACKGROUND
The aim of the study was to evaluate the use of ultrasonography (USG) including power Doppler in detecting hand and wrist joint changes in early rheumatoid arthritis (RA) and to compare USG findings with magnetic resonance imaging (MRI).
MATERIALS AND METHODS
METHODS
Thirty-four patients diagnosed as RA by 2010 ACR/EULAR criteria; with the onset of symptoms within last one year, were included in the study after institute ethical clearance and informed consent to undergo USG and contrast-enhanced MRI of the dominant affected hand. Second to fifth metacarpophalangeal (MCP) joints, second to fifth proximal interphalangeal (PIP) joints and wrist joints (total nine joints) were evaluated for synovitis, erosions along with tenosynovitis. USG and MRI features were compared; agreement on the two imaging modalities as well as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of ultrasonography compared to MRI (gold standard) was calculated.
RESULTS
RESULTS
One hundred thirty-six MCP, 136 PIP and 34 wrist joints (total 306 joints) and 136 flexor tendons were evaluated. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of USG for diagnosing synovitis was 78.6%, 91.1%, 86.1%, 85.8%, 86.3%; for erosions 67.2%, 97.5%, 84.8%, 90.5%, 91.5%; for tenosynovitis 86.5%, 100%, 100%, 92.3% and 94.8% respectively. The overall agreement between USG and MRI for detection of synovitis was achieved in 83% joints and for erosions in 89.5% joints.
CONCLUSION
CONCLUSIONS
In early RA, USG was nearly as effective in diagnosing features of joint and tendon sheath involvement, with relatively better performance of USG for tenosynovitis. The performance of USG in diagnosing erosions was limited likely due to difficult access of three-dimensional joint structure.
Identifiants
pubmed: 32850035
doi: 10.1007/s43465-020-00178-4
pii: 178
pmc: PMC7429602
doi:
Types de publication
Journal Article
Langues
eng
Pagination
695-703Informations de copyright
© Indian Orthopaedics Association 2020.
Déclaration de conflit d'intérêts
Conflict of interestThe authors declare that they have no conflict of interest.
Références
Arthritis Rheum. 1999 Jun;42(6):1232-45
pubmed: 10366117
Arthritis Rheum. 2001 Sep;44(9):2009-17
pubmed: 11592361
Arthritis Care Res (Hoboken). 2012 Aug;64(8):1238-43
pubmed: 22438306
Joint Bone Spine. 2015 May;82(3):212-3
pubmed: 25555835
Ann Rheum Dis. 2010 Jan;69(1):230-3
pubmed: 19158113
Rheumatology (Oxford). 2009 Aug;48(8):887-91
pubmed: 19474128
Semin Arthritis Rheum. 1999 Jun;28(6):368-91
pubmed: 10406405
J Rheumatol. 2007 Apr;34(4):839-47
pubmed: 17407235
Ann Rheum Dis. 2010 Feb;69(2):417-9
pubmed: 19359260
Rheum Dis Clin North Am. 1990 Aug;16(3):513-37
pubmed: 2217956
Arthritis Rheum. 1985 Sep;28(9):987-94
pubmed: 4038365
Clin Exp Rheumatol. 2008 Sep-Oct;26(5):875-80
pubmed: 19032822
Arthritis Rheum. 1977 May;20(4):1003-8
pubmed: 871301
Muscle Nerve. 1994 Jul;17(7):815-9
pubmed: 8008012
Rheumatology (Oxford). 2012 Dec;51 Suppl 6:vi5-9
pubmed: 23221588
Clin Rheumatol. 2016 Sep;35(9):2163-73
pubmed: 27122121
Arthritis Rheum. 1998 Aug;41(8):1481-8
pubmed: 9704648
Arthritis Rheum. 2013 Sep;65(9):2219-32
pubmed: 23686440
Arthritis Rheum. 2000 Dec;43(12):2762-70
pubmed: 11145034
Arthritis Res Ther. 2006;8(2):R52
pubmed: 16519793
Clin Exp Rheumatol. 2013 Jan-Feb;31(1):91-6
pubmed: 23111117
Conf Proc IEEE Eng Med Biol Soc. 2012;2012:2318-22
pubmed: 23366388