C Weidekamm1, M Köller, M Weber, F Kainberger. 1. Department of Diagnostic Osteology, Universitaetsklinik fuer Radiodiagnostik, Allgemeines Krankenhaus Wien, Waehringer Guertel 18-20, A-1090, Vienna, Austria. claudia.weidekamm@rad.akh.magwien.gv.at
Abstract
OBJECTIVE: High-resolution sonography enables a detailed assessment of intraarticular and extraarticular soft tissue abnormalities of joints affected by rheumatoid arthritis (RA). This study was undertaken to evaluate the diagnostic value of B-mode sonography and power Doppler compared with that of clinical examinations and conventional radiography. METHODS: The study group comprised 47 patients (14 men, 33 women) with different grades of RA; 31 patients were rheumatoid factor (RF) positive, and 16 were RF negative. The wrists, first through fifth metacarpophalangeal joints, and second through fifth proximal interphalangeal joints of these patients were scored with ultrasound in B-mode and power Doppler application, using a standardized technique. Involvement and severity of inflammation, as well as vascularization, were scored according to a new 3-point scale. The results were correlated with benchmarks of the clinical and radiologic investigations. Clinical status and conventional radiologic status were determined according to the Disease Activity Score and the Larsen score. RESULTS: After preliminary studies in 15 patients, 39% of 704 joints were found to be abnormal by clinical investigation. Erosions were detected by radiography and sonography in 23% and 43% of joints, respectively. Hypervascularization was observed in 34% of 704 joints by power Doppler application. There was a significant correlation (P < 0.001) between the different methods for the detection of the severity of lesions. Use of a modern, state-of-the-art power Doppler program was necessary for semiquantification, and a standardized investigation technique and scoring system provided sufficient quality measures. CONCLUSION: Sonography detects 20% more abnormalities than does radiography, and sonography has the potential to provide simple grading of disease activity. The rate of detection of abnormalities was slightly higher with clinical examination compared with sonography.
OBJECTIVE: High-resolution sonography enables a detailed assessment of intraarticular and extraarticular soft tissue abnormalities of joints affected by rheumatoid arthritis (RA). This study was undertaken to evaluate the diagnostic value of B-mode sonography and power Doppler compared with that of clinical examinations and conventional radiography. METHODS: The study group comprised 47 patients (14 men, 33 women) with different grades of RA; 31 patients were rheumatoid factor (RF) positive, and 16 were RF negative. The wrists, first through fifth metacarpophalangeal joints, and second through fifth proximal interphalangeal joints of these patients were scored with ultrasound in B-mode and power Doppler application, using a standardized technique. Involvement and severity of inflammation, as well as vascularization, were scored according to a new 3-point scale. The results were correlated with benchmarks of the clinical and radiologic investigations. Clinical status and conventional radiologic status were determined according to the Disease Activity Score and the Larsen score. RESULTS: After preliminary studies in 15 patients, 39% of 704 joints were found to be abnormal by clinical investigation. Erosions were detected by radiography and sonography in 23% and 43% of joints, respectively. Hypervascularization was observed in 34% of 704 joints by power Doppler application. There was a significant correlation (P < 0.001) between the different methods for the detection of the severity of lesions. Use of a modern, state-of-the-art power Doppler program was necessary for semiquantification, and a standardized investigation technique and scoring system provided sufficient quality measures. CONCLUSION: Sonography detects 20% more abnormalities than does radiography, and sonography has the potential to provide simple grading of disease activity. The rate of detection of abnormalities was slightly higher with clinical examination compared with sonography.
Authors: Philip J O'Connor; Andrew J Grainger; S R Morgan; K L Smith; J C Waterton; A F P Nash Journal: Eur Radiol Date: 2004-08-12 Impact factor: 5.315
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Authors: Cristina Hernández-Díaz; G Sánchez-Bringas; L Ventura-Ríos; M Robles-San Román; E Filippucci Journal: Clin Rheumatol Date: 2019-04-02 Impact factor: 2.980
Authors: Christina Duftner; Christian Dejaco; Franz Kainberger; Klaus Machold; Peter Mandl; Thomas Nothnagl; Tobias DeZordo; Rusmir Husic; Claudia Schüller-Weidekamm; Michael Schirmer Journal: Wien Klin Wochenschr Date: 2014-10-02 Impact factor: 1.704