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.
Highlights
Rheumatoid Arthritis is a chronic multisystem disease of unknown cause
Radiological examinations of hands were done by digital radiography and Power doppler ultrasound (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
The patients with polyarthritis and morning stiffness for more than one hour with disease duration of less than two years were referred with clinical diagnosis of rheumatoid arthritis
Summary
Rheumatoid Arthritis is a chronic multisystem disease of unknown cause. The potential of synovial inflammation to cause cartilage damage and bone erosions and subsequent changes in joints integrity is the hallmark of the disease. About 1% of the world’s population is afflicted by rheumatoid arthritis, women three times more often than men. Diagnosis of R.A. and appropriate therapy is the only way to save a patient from this crippling disease. MRI, though very sensitive and specific for detection of early Rheumatoid arthritis, its cost is a limiting factor. The present study will help in evaluation of the role of OPEN ACCESS
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