Background: Rheumatoid Arthritis is an auto immune long term systemic disease that leads to inflammation of joints and surrounding tissues mainly & also affects many organs. RA usually affects joints on both sides of the body equally. Wrists, fingers, knees, feet, and ankles are the most commonly affected. Aim: This study was done to evaluate role of HRUS in detection & quantification of inflammatory changes in the wrist in RA. Methods: Our study was conducted upon 50 adult patients (40 female & 10 males) with 35 patients showing active RA and 15 patients inactive with disease duration 1 to 20 years and there ages ranges from 20 to 70 year old. All patients subjected to Clinical examination, Laboratory investigations & Radiological (X-ray, Grey scale, Power Doppler US & spectral Doppler in cases of hypervascular synovitis). Results: 40 patients showed synovial thickening (80%). Effusion was detected in 35 patients by US (70%). 35 patients showed hypervascularity (70%). Erosions were detected in 30 patients (60%) by US. 24 cases showed widening of extensor tendon sheath. 14 cases showed widening of flexor tendon sheath, 24 cases showed irregularity of tendon margin, 18 cases showed loss of normal fibrillar echo texture, 6 cases showed tendon tear(partial) & 4 cases showed synovial cyst. Conclusion: we concluded that HRUS is a reliable technique for the assessment of both soft tissue changes occurring in RA patients as well as destructive joint changes. It accurately detects synovial changes, finger tendon abnormalities and bone erosions. HRUS is much better for the detection of pannus and effusion than clinical joint evaluation. HRUS is also better in the detection of bone erosions than the conventional radiography. The assessment of synovial pannus perfusion by the use of color/power Doppler techniques may prove to be an important objective in evaluating synovitis activity and differentiating between inactive and active pannus in rheumatoid joint. |
