Quantitative ultrasound can detect early rheumatoid arthritis

הסקירה באדיבות מדיקונטקסט:Last Updated: 2001-07-18 13:49:50 EDT (Reuters Health)

LONDON (Reuters Health) – Quantitative ultrasound (QUS) can detect the early phalangeal bone loss and inflammation associated with rheumatoid arthritis (RA), according to two reports published in the July issue of Annals of the Rheumatic Diseases.

In one study, Dr. C.-C. Gluer, from the Universitatsklinikum in Kiel, Germany, and colleagues assessed the ability of QUS to detect phalangeal bone loss in 29 women with glucocorticosteroid (GC)-treated RA. Twenty-four women with GC-treated vasculitis and 30 healthy women served as the control groups. QUS measurements were taken at the metaphyses of the proximal phalanges II-V and at the proximal interphalangeal joints II-IV.

Women with RA had decreased amplitude-dependent speed of sound (AD-SoS) values compared with controls, a finding indicative of phalangeal bone loss. Even women with RA who had no evidence of erosions on hand radiographs had significantly decreased AD-SoS values. However, when erosion did become apparent, these values deteriorated further.

"QUS is a simple, portable, and inexpensive technique that is free of ionising radiation," the authors point out. "Because of the promising results for precision and sensitivity to early changes in RA we suggest that its clinical use for monitoring skeletal changes in early RA should be evaluated in prospective studies."

In another study, Dr. H. Bliddal, from the Frederiksberg Hospital in Denmark, and colleagues assessed the ability of QUS to detect phalangeal synovial inflammation in 18 patients with RA. Two independent observers evaluated the sonographic data for synovial area and thickness, vascularisation, and indices of intra- and extrasynovial arterial flow.

The researchers found that QUS was a reliable method of detecting joint space and vascular changes associated with synovial inflammation.

"In the not too distant future, sonographic equipment may be available in many rheumatology departments," the investigators note. "Teaching simple procedures, such as estimating local signs of inflammation or finding minor effusions in the joint, will be simplified, thus pointing to yet another application for ultrasonography in the daily clinic."

Ann Rheum Dis 2001;60:670-677,690-693.

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