The role of ultrasonography in evaluation of hand and wrist joints in patients with rheumatoid arthritis

Background
Ultrasound (US) has been increasingly applied over the last decade to assess disease activity and the response to therapy in patients with rheumatoid arthritis.


Aim
The aim of the study was to highlights the role of grey scale ad power Doppler ultrasound in evaluation of rheumatoid arthritis diseases in hands and wrist joints.


Patients and methods
This prospective study included a total of 30 patients with rheumatoid arthritis were collected from the Rheumatology outpatient clinic, Al-Hussein University Hospital. This study was conducted between June 2019 to January 2020.


Results
By gray scale ultrasound, synovial thickening was detected in 30 patients (100%), active synovitis detected by using Doppler US in 15 patients (50%), effusion was detected in 20 patients (66.7%), bone erosions were detected in 6 patients (20%) and X-ray finding was detected in 1 patients (3.3%). There is no positive correlation between X ray and any other sonographic nor laboratory finding. On the other hand, a positive correlation between ultrasound detected synovial hypertrophy, joint effusion and power doppler. Also, Power Doppler has a positive correlation with synovial hypertrophy, bone erosions, Erythrocyte Sedimentation Rate and Disease Activity Score.


Conclusion
Grey scale ultrasonography (GSUS) is a reliable technique for assessment of both soft tissue and erosive joint changes occur in early stage in rheumatoid arthritis. Also, power doppler ultrasonography (PDUS) can evaluate synovitis and differentiating between inactive and active synovial hypertrophy.