Correlation of Classical Skiagraphy, Ultrasonography and Magnetic Resonance Imaging in the Evaluation of Early Rheumatoid Arthritis

Overview

Objective.
To confirm by correlation of the ultrasound examination and magnetic resonance thevalidity of these imaging algorithms in the detection of early morphological changes of the hand inincipient rheumatoid arthritis. Methods. The authors examined 80 patients with the clinical diagnosis of early rheumatoid arthritis. In all probands X-ray pictures of the hands were made and thestage was assessed according to Steinbrocker. The patients were at the same time examined byultrasound and magnetic resonance and the results of the evaluation were entered in a uniformexamination protocol. By means of both methods morphological changes of all joints, flexors andextensors were evaluated. Results. A total of 1760 joints were examined. Examination b y ultrasoundand magnetic resonance were in detection of inflammatory changes in early rheumatoid arthritissignificantly more sensitive than conventional skiagraphy. Both imaging techniques are approxi-mately equally sensitive in detection of tenosynovitis (ultrasound examinations 50.1 % detection,magnetic resonance 49.9 %). In evaluation of synovialitis magnetic resonance is more sensitive(58 %), while exudates are better evaluated by ultrasound examination (58.70 %). Synovialitis wasproved in 66 patients of 80. By magnetic resonance it was proved in 456 joints, by ultrasound onlyin 330. An exudate in the joint was detected in 51 patients of 80; sonography 186x and 124x bymagnetic resonance. Tenosynovitis was found in 44 patients of 80, the results were alm ost identical(ultrasound 174x, magnetic resonance 173x). On correlation of both methods on a signal joint(metacarpophalangeal articulation of the second finger of the right hand) agreement of the twotechniques was 70 %. Statistical evaluation was made by the t-test, the level of significance ultra -sound/magnetic resonance in synovialitis was p < 0.001, in exudate p < 0.005, in tenosynovitis p

Key words:
sonography, magnetic resonance, early rheumatoid arthritis