Objective
This study aimed to highlight the diagnostic value of musculoskeletal ultrasonography (US) in
the evaluation of inflammatory changes in the shoulders of rheumatoid arthritis (RA) patients
and to correlate those findings with the clinical, laboratory, and radiological parameters of the
disease activity.
Patients and methods
This study included 40 RA patients diagnosed according to the 2010 American College of
Rheumatology/European League Against Rheumatism classification criteria for RA. In addition,
20 age-matched and sex-matched healthy individuals were included. US assessment was
performed bilaterally in RA patient’s shoulder and unilaterally in controls. All US examinations
were carried out using LOGIQ P6 PRO machine equipped with 6–8 MHz broadband
multifrequency linear transducer.
Result
US on shoulders detected that 21 (52.5%) RA patients studied had erosions, 18 (45%) RA patients
had synovitis, 21 (52.5%) RA patients had tenosynovitis, seven (17.5%) RA patients had bursitis,
and 18 (45%) RA patients had rotator cuff tendinopathy. There was a significant relation between
US-detected erosion in RA patients and disease duration (P = 0.037) and rheumatoid factor
(RF) level (P = 0.02), whereas there was no significant relation between US-detected erosion
in RA patients and shoulder pain (P = 0.185), Disease activity score 28 (DAS28) (P = 0.163),
erythrocyte sedimentation rate (P = 0.519), and C-reactive protein levels (P = 0.561). There was
a significant relation between US-detected tenosynovitis in RA patients and shoulder pain (P =
0.025). There was no significant relation between US-detected bursitis in RA patients and disease
duration (P = 0.970), shoulder pain (P = 0.907), DAS28 (P = 0.471), erythrocyte sedimentation
rate (P = 0.220), and RF levels (P = 0.755), whereas there was a significant relation between
US-detected bursitis in RA patients and C-reactive protein (P = 0.036).
Conclusion
US became a problem-solving approach and the tool of choice for cases with shoulder problem,
and can provide an accurate answer to many clinical questions and give an accurate diagnosis
of different |
