Role of Ultrasound & Power Doppler of Wrist & Hand Joints in Diagnosisof Early Symptomatic Cases of Rheumatoid Arthritis

Abstract

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by the development of synovitis, which damages cartilage, bone, ligaments, and tendons. It preferentially affects the small joints of the hands and feet leading to synovial inflammation and various degrees of destruction of periarticular tissues. Synovial inflammation is accompanied by hyperemia, and during disease progression, angiogenesis in a hypervascularized of synovial hypertrophy appears to be a prerequisite for erosion to cartilage and bone. The evaluation of perfusion of synovial hypertrophy proved to be an important objective in evaluating synovial activity. Accurate assessment of disease activity and joint damage in rheumatoid arthritis is important for monitoring treatment efficiency and for prognoses of the disease. This requires sensitive imaging methods for detection and monitoring of the disease process. High resolution ultrasound (HRUS) has become an established imaging technique for the diagnosis and follow-up of patients with rheumatoid arthritis. HRUS is most commonly used in the assessment of soft tissue disease or detection of fluid collection and can also be used to visualize other structures, such as cartilage and bone surfaces. HRUS complements the physical examination by allowing for visualization of synovitis and erosive changes. assessment of the degree of inflammation can be obtained with the use of color or power Doppler US.