High Resolution Ultrasound Applications In The Small Joints Of Rheumatoid Arthritis Disease

Objective: To investigate the diagnostic value of high-resolution ultrasound in rheumatoidarthritis (Rheumatoid Arthritis, RA) finger facet joint lesions.Materials and Methods: Select patients with rheumatoid arthritis in Dalian city center hospitalas the research object, who are in line with American College of Rheumatology1987reviseddiagnostic criteria for rheumatoid arthritis, Total of40patients were720small joints of thefingers as RA group, while20cases of normal small joints of the fingers360as the contrast group,the application of high-resolution ultrasound examination two hands1-5metacarpophalangeal joint(Metacarpophalangeal joint, MCP) and2-5proximal interphalangeal joints (Proximalinterphalangeal joint, PIP), observe and record the synovial membrane thickness and blood flow,range of joint accumulate liquid and sound transmission, the articular soft bone and subchondralbone surface is smooth, surface and interior condition, with or without defects. By comparison withthe contrast group, observe the small joints of the fingers rheumatoid lesions high-resolution colorDoppler ultrasonography, summarize the characterized of small finger joints of rheumatoid arthritisdisease by ultrasound, at the same period MRI performed20patients (Magfletic Resonance Imaging,MRI), the positive rate compare high resolution ultrasound with MRI lesions in the small joints ofrheumatoid arthritis finger check.Results:1small joints of the fingers lesions ultrasound results:1.1synovial thickening:358detected40cases of synovial thickening, representing100%ofthe total number of patients (40/40) and49.72%of total joint subjects (358/720)respectively, metacarpophalangeal joint and proximal interphalangeal joints，detection rate was58.50%(234/400) and38.75%(124/320) respectively.1.2joint accumulate liquid:310detected29cases of articular joint accumulate liquid,72.50%of the total number of patients (29/40) and43.06%(310/720) of the total subjectsjoints respectively, MCP, PIP’s inspection rate was46.00%(184/400) and39.38%(126/320)respectively.1.3synovial pannus: Class I according to flow more positive signal, RA group of17patients85were positive flow signal, representing42.50%of the totalnumber of patients (17/40) and11.81%of total joints were inspected (85/720),MCP, PIP detection rate was16.50%(66/400) and5.94%(19/320) respectively.1.4bone damage:79lesions detected in11cases of articular cartilage andsubchondral bone erosion,27.50%of the total number of patients (11/40) and10.97%of the total number of subjects joint (79/720) respectively, MCP, PIPThe detection rate was14.00%(56/400) and7.19%(23/320) respectively.2. Small joints of the fingers lesion MRI detection results:2.1synovial thickening:241detected14cases of synovial thickening,70.00%of the totalnumber of patients (14/20) and66.94%of total joint subjects (241/360) respectively.2.2joint accumulate liquid:167detected12cases articular joint accumulate liquid,60.00%ofthe total number of patients (12/20) and46.39%of the total joint subjects (167/360)respectively.2.3Bone damage:65detected8cases lesion articular cartilage and subchondral boneerosion,40.00%of total number of patients (8/20) and18.06%of the total subject joint(65/360) respectively.3. Comparison of the results:3.1high-resolution ultrasonography synovial thickness comparison: RA synovial thickness wassignificantly thicker than in the contrast group, the difference was statistically significant(P <0.01).3.2high-resolution ultrasound and MRI examination results comparison:20patients with RA,MCP and PIP synovial thickness, joint effusion, bone damage to the two kinds of imagingtests positive rate, the difference was not statistically significant (P>0.05). Conclusions:1. High resolution ultrasound can be detected in rheumatoid synovial thickening and jointaccumulate liquid, ultrasound can be used as an important indicator of the small joints of the fingersdiagnosis of rheumatoid arthritis disease.2. Color Doppler flow imaging in detecting the distribution of blood flow signals within thesynovium is an important indicator to determine the degree of synovial inflammation of rheumatoidarthritis and inflammatory activity in nature.3. High resolution ultrasound detection of articular cartilage and subchondral bone erosion ofbone is to determine the severity of the small joints of rheumatoid arthritis finger importantreference.