Abstract

Background: To compare ultrasonographic of periarticular soft-tissue findings in the early active stages of rheumatoid arthritis to clinical findings in the joints.
Material/Methods: Gray-scale sonographic examinations of hand joints were performed in healthy subjects (n=30, 20 female and 10 male, aged 18-59, mean age 44.7) and prospectively in patients suspected to have early active rheumatoid arthritis (n=23, 18 female and 5 male, aged 17-57, mean age 43.2). Patient' selection was based on American Rheumatoid Association criteria and radiographic exam. Gray-scale sonography of proximal-interphalangeal, metacarpophalangeal and wrist joints was performed with real-time linear-array 7.5 MHz probe (SSH 140A; Toshiba).
Results: The mean thickness of periarticular hypoechoic rim around examined joints in control group was 0.91±0.18mm (SD) and in patients group 2.7±1.2mm (SD). In the cases of RA, moderate rim thickening (1.2-5mm) was observed in 14 asymptomatic joint areas (mean 2.3±0.8mm SD) and in 52 symptomatic joints (mean 3.2±0.7mm SD). Severe rim thickening (over 5mm) was observed in 48 symptomatic joints (mean 6.2±1.6mm). The distribution of the sonography and clinical findings in early RA was different from that in healthy subjects (p<0.001).
Conclusions: Sonography was found to be more accurate and objective procedure than physical examination of the hands. It might justify the routine use of this method in early RA.

Keywords: Arthritis, rheumatoid, ultrasound