Musculoskeletal ultrasound versus MRI of the hands in healthy subjects - a pilot study.

Abstract

High resolution imaging methods detect a spectrum of inflammatory-like and structural modifications at joint andtendon level in healthy subjects. The knowledge of their extent and degree is important when subclinical disease activity (implyingtherapy reassessment) must be differentiated from normality. Musculoskeletal ultrasound (MSUS) evaluation may bechallenging even for experts when borderline or low grade lesions are present. Our objective was to analyse the frequency ofinflammatory-like lesions in hand joint and tendons in healthy young subjects and to evaluate the concordance between MSUSand magnetic resonance imaging (MRI) findings. Ten healthy young women (age range 24-32 years)clinically asymptomatic (joints and tendons) were selected to have bilateral hand MSUS and MRI evaluation. Based on currentdefinitions, synovitis/tenosynovitis-like lesions, erosions, osteophytes and bone edema were quantified and concordancebetween the two imaging methods was calculated. Overall, both imaging evaluation methods showed a low frequencyof inflammatory-like and structural lesions. No joint presented power Doppler signal or erosions. No abnormalities suggestivefor inflammatory or structural pathology were detected at the tendon compartments level. No erosions and no signs of osteitiswere detected. The concordance between MSUS and MRI findings was high except for the wrist area. MSUS wasdemonstrated to be a very accurate imaging method, mostly for hand tendon evaluation. This would allow a better discriminationbetween normality and pathologic findings, adding supplementary information.