The Utility of Duplex Doppler in Assessment of Rheumatoid Arthritis in Small Joints

Abstract

heumatoid arthritis (RA) is an inflammatory rheumatic disease with progressive course affecting articular and extra-articular structures resulting in pain, disability and mortality. It is of unknown etiology, which primarily affects the synovia; where the persisting synovitis of symmetric peripheral joints can lead to structural damage of cartilage, bones, tendons, and ligaments. The disease affects approximately 1% of the world’s population. Persistent inflammation leads to erosive joint damage and functional impairment in the vast majority of patients. The onset of disease is not similar in all patients but varies in regard to type, number, and the pattern of joint involvement. The course of disease may be also different according to the presence or absence of several variables including genetic background, frequency of swollen joints, autoantibody in the serum and the severity of inflammatory process. Evaluation of disease activity in rheumatoid arthritis (RA) is essential in the routine clinical management of RA patients and in RA clinical trials. Disease activity in RA joints is conventionally assessed clinically (e.g., assessment of joint swelling/tenderness) in combination with the measurement of levels of biochemical surrogate markers such as serum C-reactive protein.