Application Of Musculoskeletal Ultrasound In The Clinical Diagnosis And Range Of Motion Evaluation Of Rheumatoid Arthritis

BackgroundAs a common autoimmune disease,rheumatoid arthritis(RA)is characterized by invasive synovitis of the joints,which not only has the risk of disability,but also indues a series of cardiovascular adverse events.Therefore,early diagnosis and treatment is of great significance.Musculoskeletal ultrasound has the most ideal effect in the clinical diagnosis of RA,and fully reflects the advantages of simple operation and moderate price,which can provide an important theoretical basis for its follow-up treatment.However,at present,there are few studies on musculoskeletal ultrasound for RA diagnosis in China,especially on patients’ activity level.Based on this,this study took application of musculoskeletal ultrasound in the clinical diagnosis and range of motion assessment of rheumatoid arthritis as the research subject,hoping to clarify the clinical application value of musculoskeletal ultrasound in the clinical diagnosis and range of motion assessment of RA,so as to guide and promote the level of diagnosis and treatment of RA patients.Objective1.To explore the detection status of musculoskeletal ultrasound in RA lesions and the number of joints,and to analyze the value of musculoskeletal ultrasound in the clinical diagnosis of RA.2.To explore the correlation between musculoskeletal ultrasound parameters and RA joint activity,and to clarify the value of musculoskeletal ultrasound in the evaluation of RA joint mobility.MethodSixty patients with RA admitted to the rheumatism department of the people’s hospital of Anyang from February 2018 to February 2019 were included as the study subjects.All the 60 cases underwent MRI imaging examination and musculoskeletal ultrasound imaging examination of 22 joints including the wrist joint,1st～5th metacarpophalangeal joint,the 1st interphalangeal joint and the 2nd ～ 5th proximal interphalangeal joint.The imaging characteristics of all cases were analyzed,and the differences in detection rates between musculoskeletal ultrasound and MRI in RA joint lesions and the number of diseased joints were compared to analyze the diagnostic value of musculoskeletal ultrasound and MRI in various types of RA joint lesions.On this basis,the analysis of different activity of the RA cases imaging findings,contrast different activity activity index of the RA cases,ultrasonic imaging score,on the analysis of the orrelation between ultrasonic imaging score and RA activity index,on the basis of further explore ultrasonic imaging score in RA activity evaluation of effectiveness.Result1.MRI could be used to demonstrate synovial lesions,tendinopathy,bone erosion lesions and bone marrow edema lesions of RA by imaging.Musculoskeletal ultrasound could clearly show the structure,echo,level and blood flow signal of the synovial,tendon and cartilage tissues in the joint.2.There were no statistically significant difference between the detection rates of synovial hyperplasia and joint effusion diagnosed by musculoskeletal ultrasound and MRI diagnosis(P>0.05).The detection rates of joint bone erosion diagnosed by musculoskeletal ultrasound were lower than those of MRI diagnosis,the difference was statistically significant(P<0.05).3.All the 60 patients showed varying degrees of limited range of motion,with an average DAS28 score of 4.11±1.33 points,including 18 cases of severe limited motion,20 cases of moderate limited motion,14 cases of mild limited motion,and 8 cases of unrestricted motion in remission.Synovial thickening of joints was the main musculoskeletal imaging manifestations of RA cases,and the higher the degree of synovial thickening of joints,the clearer the imaging manifestations of musculoskeletal ultrasound lesions.Ultrasound imaging score was positively correlated with DAS28 score(r=0.793,P<0.05),ESR(r=0.741,P<0.05),and hs-CRP(r=0.725,P<0.05).Synovial lesion,blood flow signal of the synovial,joint effusion,bone erosion lesion in not limited cases,mild cases,moderate limited cases,severe cases(r=0.714,0.735,0.697,0.630,P<0.05)were positively correlated.Ultrasonic imaging identification evaluation scoring is useful in RA activity evaluation of effectiveness.Conclusion1.Synovium lesions,joint effusion,joint bone erosion lesions are the main imaging diagnosis differentiate RA basis.Musculoskeletal ultrasound and MRI are the same sensitive in RA synovium lesions,RA joint effusion lesions,MRI is more sensitive than musculoskeletal ultrasound in RA joint bone erosion.Musculoskeletal ultrasound can be used in RA synovium lesions,RA joint effusion,RA joint bone erosion in the diagnosis of lesions identified.2.There was a correlation between musculoskeletal ultrasound score and the range of motion index of the joints similar to RA,musculoskeletal ultrasound has its application prospect in the evaluation of the range of motion of the joints of RA patients.