Application Of High-frequency Ultrasound In The Detection Of Finger And Wrist Joints In Patients With Early Rheumatoid Arthitis

Objective:To research the performance of sonographic of early erosions of hand joints in patients with early rheumatoid arthritis and to investigate the applications of high-frequency ultrasonography in the early diagnosis of the early rheumatoid arthritis (RA).Methods:Double wrists, the first to the fifth Metacarpal phalangeal joint (MCP) and Proximal interphalangeal joint (PIP) of 53 RA patients and 30 controls matched of age, gender were examined by high-frequency ultrasonograph. The thickness of synovial membranes, extensor tandon sheath and flexor tendon sheath were measured. The synovial blood flow signals, cartilege damages, bone erosion and Tendon lesions were observed.Results:The average thickness of synovium, extensor tendon and flexor tendon sheath of the early RA patients was greater than the controls (p<0.001). No thickening of synovial, synovial blood flow signals, cartilege damage,bone erosion and tendon abnormality were found in controls. In RA group,14.15% joints had joint effusion, 5.23% joints had cartilage erosions,2.32% joints had bone erosions. The detection rates of tendon effusion and tendon adhesions were 19.81% and 16.30%.8.92% joints had synovial blood flow signals by color Doppler flow image(CDFI) and color Doppler energy (CDE), which accounts for 4.37% active stage with the RI value of synovial artery (0.58±0.07)and inactive stage accounts 0.94% with the RI value of synovial artery (0.67±0.03). The were statistically signicant difference in Anti-CCP antibody positive group and anti-CCP antibody-negative group. Anti-CCP antibody positive group had higher bone erosion than anti-CCP antibody-negative group. Conclusions:1. High-frequency ultrasonography can detect joint effusion, thickening of synovitis, tendon changes and bone erosion in the early stage of RA.2. Tendon lesions around the joint can found by high-frequency ultrasound in early RA, including tenosynovitis, tendon sheath and tendon adhesion.3. There was evidence that synovial blood flow signals and the RI value of synovial artery which detected by urtrasonography have associated with diease activity.4. Anti-CCP antibody positive group had higher bone erosion than anti-CCP antibody-negative group.