The Clinical Study Of Ultrasonography In Diagnosis Of Hand Joints Of Early Rheumatoid Arthritis

To investigate the characterization of Colour Doppler Ultrasonography(CDUS) in observing the clinical diagnosis and highly suspecte but not confirmed examination of hand joints in early rheumatoid arthritis (RA), and the result compared to gold targets Magnetic resonance imaging(MRI) to explore the clinical evaluation of CDUS in diagnosing early RA.1.60 patient s who were known as RA clinically were selected according to 1987 American Rheumatism Assosiation(ARA) revised criteria,18 of them were highly suspected and their laboratory tests were negative initially(converted into positive later). Healthy volunteers were 20.2. Wrists, 1-5metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints of 60 RA patients and 20 healthy volunteers were examined by colour Doppler ultrasonography using high frequency linear-array transducer,dorsal and palmar, respectively longitudinal and transverse scanning. Observed synovial thickness, intra-articular fluid, periarticular changes, tendon lesion, bone joint surface is smooth, with or without bone destruction. Found pannus though observing blood sign within the synovial membrane with Color Doppler Flow Imagining. Recorded positive j oints.Values of synovial thickness are expressed as means±SDs (mm). The standard Student paired t test was used for comparing synovial thickness of RA and healthy volunteers, P<0.05 was statistically significant.3.25 selected from 60 patients underwent both hands MRI examination simultaneously. Two Imaging diagnosis were compared, explored their relevance. Qualitative data were compared by using the x2 tests for paired data. Results were considered significant at the 5% critical level (P<0.05).4. Comparison of the positive rate of two imaging methods for early RA diagnosis was performed applying the x2 tests, P<0.05 was statistically significant.1. Ultrasonographic features of normal hand joints:Ultrasonography shows the organizational structure around the joints and joints neat, clear layer. From the outside to inside, we can observe:skin, subcutaneous tissue, tendon, synovium, cartilage and bone surface. Synovial is thin and hypoecho, and synovial fluid can not distinguish. Tendon fiber is medium echo, longitudinal shape is rule, cross-section is circular, or oval; tendon sheath is clear and low-echo. Articular cartilage echo is low, the thick is uniform. Cortical is continuous, smooth and high echo. We do not find color flow signal on the surface and internal synovial with CDFI.2. Ultrasonographic features of small hand joints in of 60 patients with early RA 2.1 Synovitis of joints was found in 55 RA patients (457 joints), (91.67% and 34.62%). 2.2 Intra-articular fluid was found in 51(247 joints),(85.00% and 18.71%). 2.3 Pannus was detected in 21(66 joints),(35.00% and 5.00%). 2.4 Periarticular inflammation tissue was detected in 14(32 joints),(23.33% and 2.42%). 2.5 Bone erosions were found in 4(33 joints),(6.67% and 2.5%).3. The synovial membrane of RA was thicker than that of healthy volunteers.There were statistical significances in 21 of 22 joints in the two groups.4. Two Imaging diagnosis was positively correlation. Correlation coefficient was 0.43 the correlation coefficient of wrist,MCP and PIP was 0.48,0.51 and 0.34.5. The positive rate of two imaging methods in wrist and MCP and all the hand joints, the difference was not statistically significant; in PIP was statistical significances.1. Color Doppler sonography can detect early synovial changes in RA.2. The examining result of Color Doppler ultrasound can be earlier than laboratory diagnosis in some patients.3. Diagnosis in Colour Doppler Ultrasound can be reliable in examining the hand joints synovial changes of early RA patients.It can provide a reference for clinical diagnosis of RA.