OJRA  Vol.4 No.1 , February 2014
Comparative Study of Radiological Changes in Hands and Feet in Patients Suffering from Early Rheumatoid Arthritis by Power Doppler Ultrasound and Direct Digital Radiography
Abstract: Rheumatoid arthritis is a chronic multisystem disease of unknown cause. The characteristic feature of RA is persistent inflammatory synovitis. The natural history of disease is such that the early months of the disease are critical period during which reversible joint damage occurs. So early diagnosis of RA and appropriate drug application is the only way to save a patient from this crippling disease. In India, the cost of investigations is a significant factor for most of the patients. Ultrasonography or Power Doppler Ultra Sound (PDUS) has the advantage of being economic in spite of its sensitivity in assessing both inflammatory and destructive changes. The aim of the present study was to evaluate the diagnostic efficiency of PDUS in early rheumatoid arthritis. The study was performed with the patients attending Rheumatology Clinic. A total number of 106 patients of clinically suspected rheumatoid arthritis were studied as per selection criteria. Radiological examinations of hands were done by digital radiography and PDUS in a group of 53 patients, assessment of foot changes by PDUS and Digital Radiography were done in another similar group of 53 patients. Final diagnosis by ACR EULAR-2010 criteria is done for all the patients. The comparative study reveals that synovial vascularity as demonstrated by PDUS is much more effective in diagnosing early rheumatoid arthritis, both in hand and in feet than digital radiograph. PDUS of feet may yield earlier and better findings than hands, which is conventionally used in patients suffering from early rheumatoid arthritis.
Cite this paper: G. Mondal, B. Ghosh, M. Ghosh and P. Halder, "Comparative Study of Radiological Changes in Hands and Feet in Patients Suffering from Early Rheumatoid Arthritis by Power Doppler Ultrasound and Direct Digital Radiography," Open Journal of Rheumatology and Autoimmune Diseases, Vol. 4 No. 1, 2014, pp. 39-42. doi: 10.4236/ojra.2014.41006.

[1]   D. Aletaha, T. Neogi, A. J. Silman, et al., “Rheumatoid Arthritis Classification Criteria: An American College of Rheumatology/European League against Rheumatism Collaborative Initiative,” Annals of the Rheumatic Diseases, Vol. 69, No. 9, 2010, pp. 1580-1588.

[2]   M. Dougados, et al., “The Ability of Synovitis to Predict Structural Damage in Rheumatoid Arthritis: A Comparative Study between Clinical Examination and Ultrasound,” Annals of the Rheumatic Diseases, Vol. 72, No. 5, 2013, pp. 665-671.

[3]   “Text Book of Radiology and Imaging,” 7th Edition, Vol. 2, David Sutton, p. 1201.

[4]   V. Devauchelle Pensec, A. Saraux, J. M. Berthelot, S. Alapetite, et al., “Ability of Foot Radiographs to Predict Rheumatoid Arthritis in Patients with Early Arthritis,” Journal of Rheumatology, Vol. 31, No. 1, 2004, pp. 66-70.

[5]   F. C. Arnett, S. M. Edworthy, D. A. Bloch, et al., “The American Rheumatism Association 1987 Revised Criteria for the Classification of Rheumatoid Arthritis,” Arthritis & Rheumatism, Vol. 31, No. 3, 1988, pp. 315-324.

[6]   D. Van der Heijde, “How to Read Radiographs According to the Sharp/van der Heijde Method. Prediction of Radiological Outcome in Early Rheumatoid Arthritis in Clinical Practice,” Journal of Rheumatology, Vol. 26, 1999, pp. 743-745.