Manel Limeme, Abstract Co-Author: Nothing to Disclose

Neila Benzina, Abstract Co-Author: Nothing to Disclose

Moncef Allegue MD, Abstract Co-Author: Nothing to Disclose

Houneida Zaghouani Ben Alaya, Abstract Co-Author: Nothing to Disclose

Senda Majdoub, Abstract Co-Author: Nothing to Disclose

habib amara, Abstract Co-Author: Nothing to Disclose

dejla bakir, Abstract Co-Author: Nothing to Disclose

Chakib Kraiem MD, DMD, Presenter: Nothing to Disclose

To evaluate concordance between clinical examination and ultrasound of joints (hands) in an heterogeneous group of patients with rheumatoid arthritis (RA).To compare sonography with conventional radiography for the detection of erosions in the metacarpophalangeal (MCP) joints of patients with RA.  

Forty patients were included in a prospective, transversal, single-center study, whatever disease activity, duration or treatment. In each patient, both hands were evaluated for a total of 960 joints. Synovitis was scored using clinical examination, B-mode and power Doppler. Concordance between swelling joint by clinical examination, synovitis thickening by B-mode (grade 1 or higher) and inflammation by power Doppler (grade 1 or higher) was assessed by computing the kappa coefficient. Erosion sites were recorded using radiography and sonography and subsequently compared using each modality.  

Clinical joint examination and ultrasound concordance was very low at the metacarpophalangeal joints (κ < 0.1) and was low at wrists (κ: 0.23 to 0.30). B-mode and power Doppler found 350 more synovitis than swollen joint count using clinical examination and up to 228 times more at metacarpophalangeal joints. Sonography detected 127 definite erosions in 56 of 100 RA patients, compared with radiographic detection of 32 erosions (26 % of which coincided with sonographic erosions) in 17 of 100 patients (P < 0.0001). The mean duration from the onset of symptoms was 3.46 months. Based on the clinical, biochemical and US scores the patients from our study presented early stages of RA. Also, statistically significant correlations were observed between the time elapsed from the onset, the changes highlighted by ultrasound and the stage of the disease.  

Our study confirms that US evaluation of changes in the joints of the hand offers useful information for staging the diagnosis of RA as it determines the activity of the disease thanks to Doppler parameters. It is a reliable technique that detects more erosions than radiography, especially in early RA. This technology has potential in the management of patients with early RA and is likely to have major implications for the future practice of rheumatology.

US evaluation of changes in the joints of the hand offers useful information for staging the diagnosis of RA as it determines the activity of the disease thanks to Doppler parameters. 

Limeme, M, Benzina, N, Allegue, M, Ben Alaya, H, Majdoub, S, amara, h, bakir, d, Kraiem, C, Rhumatoid Arthritis: Correlations betwween Ultrasound and Radiograpic Images and betwween Ultrasound and Clinical Findings  .  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14011646.html