OBJECTIVE: To evaluate the sensitivity and predictive value of grey scale and power Doppler ultrasound assessment of bone erosionin disease activity in patients with early rheumatoid arthritis (RA). METHODS: Fifty-six patients with early RA underwent blinded sequential clinical, laboratory and ultrasound assessments, and at the same time 20 of these patients underwent X-ray and enhanced MRI. For each patient, 28-joint disease activity score (DAS28), erythrocyte sedimentation rate (ESR), C reactive protein (CRP) and health assessment questionnaire (HAQ) were recorded. The presence of bone erosion and synovitis was investigated in 28 joints by gray-scale and power Doppler ultrasonography. The ultrasound joint count and index for active synovitis with power Doppler signal were calculated. RESULTS: The number of bone erosions detected by ultrasonography was 5.7 times that of X-ray, while both MRI and ultrasonography were consistent (91.5%). The number of synovitis detected by ultrasonography was 1.6 times as much as by physical examination, and consistent MRI (95.7%). PDUS parameters demonstrated a highly significant correlation with DAS28, ESR and CRP, while a negative correlation with HAQ. CONCLUSION: Grey scale and power Doppler ultrasonography is a sensitive and reliable method to assess bone erosion and inflammatory activity in early RA. PDUS findings may have a predictive value in disease activity.
OBJECTIVE: To evaluate the sensitivity and predictive value of grey scale and power Doppler ultrasound assessment of bone erosionin disease activity in patients with early rheumatoid arthritis (RA). METHODS: Fifty-six patients with early RA underwent blinded sequential clinical, laboratory and ultrasound assessments, and at the same time 20 of these patients underwent X-ray and enhanced MRI. For each patient, 28-joint disease activity score (DAS28), erythrocyte sedimentation rate (ESR), C reactive protein (CRP) and health assessment questionnaire (HAQ) were recorded. The presence of bone erosion and synovitis was investigated in 28 joints by gray-scale and power Doppler ultrasonography. The ultrasound joint count and index for active synovitis with power Doppler signal were calculated. RESULTS: The number of bone erosions detected by ultrasonography was 5.7 times that of X-ray, while both MRI and ultrasonography were consistent (91.5%). The number of synovitis detected by ultrasonography was 1.6 times as much as by physical examination, and consistent MRI (95.7%). PDUS parameters demonstrated a highly significant correlation with DAS28, ESR and CRP, while a negative correlation with HAQ. CONCLUSION: Grey scale and power Doppler ultrasonography is a sensitive and reliable method to assess bone erosion and inflammatory activity in early RA. PDUS findings may have a predictive value in disease activity.