Clinical rheumatology · 2025
Ultrasound of the wrist in low disease rheumatoid arthritis patients: Intercarpal joint is more sensitive than radio-carpal and distal radio-ulnar joint.
СтатьяНазвание и аннотация: Перевод в очереди
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Lu Yueh-Chien, Chen Ying-Chou
Аннотация
OBJECTIVES: Musculoskeletal ultrasound (MSUS) assessment of disease activity is a valuable tool for guiding therapeutic decisions within a treat-to-target strategy. This study aimed to assess synovitis activity in the wrist joint at different levels using ultrasonography (US) in patients with rheumatoid arthritis (RA).
METHODS: Gray scale synovial hypertrophy (SH) and power Doppler (PD) ultrasound were performed on the dorsal radio-scaphoid, inter-carpal, and radio-ulnar joints of the dominant wrist. A one-way ANOVA with multiple comparisons was conducted for each joint.
RESULTS: A total of 38 patients with RA and wrist joint involvement underwent a standardized PD examination assessing three positions in the wrist. The mean synovial hypertrophy (SH) was 1.08 ± 0.487 at the radio-carpal joints, 1.08 ± 0.487 at the inter-carpal joints, and 0.45 ± 0.602 at the radio-ulnar joints, with significantly higher values at the radio-carpal and inter-carpal joints compared to the radio-ulnar joints. The mean power Doppler (PD) was 0.08 ± 0.273 at the radio-carpal joints, 0.79 ± 0.577 at the inter-carpal joints, and 0.16 ± 0.437 at the radio-ulnar joints, with significantly higher values at the inter-carpal joints. Overall, the inter-carpal joint demonstrated greater sensitivity than the other joints.
CONCLUSIONS: Ultrasound assessment of wrist joints should include intercarpal joints, as they frequently show increased power Doppler activity, indicating higher inflammatory activity. Key Points • The intercarpal joint is the most important component of the wrist for detecting ultrasound activity in clinical practice, particularly in patients with low disease activity in RA patients. • Musculoskeletal ultrasound (MSUS) assessment of disease activity may serve as a valuable tool for guiding therapeutic decisions within a treat-to-target strategy. Further studies are needed to optimize ultrasound evaluation and validate its measurements for clinical use.
METHODS: Gray scale synovial hypertrophy (SH) and power Doppler (PD) ultrasound were performed on the dorsal radio-scaphoid, inter-carpal, and radio-ulnar joints of the dominant wrist. A one-way ANOVA with multiple comparisons was conducted for each joint.
RESULTS: A total of 38 patients with RA and wrist joint involvement underwent a standardized PD examination assessing three positions in the wrist. The mean synovial hypertrophy (SH) was 1.08 ± 0.487 at the radio-carpal joints, 1.08 ± 0.487 at the inter-carpal joints, and 0.45 ± 0.602 at the radio-ulnar joints, with significantly higher values at the radio-carpal and inter-carpal joints compared to the radio-ulnar joints. The mean power Doppler (PD) was 0.08 ± 0.273 at the radio-carpal joints, 0.79 ± 0.577 at the inter-carpal joints, and 0.16 ± 0.437 at the radio-ulnar joints, with significantly higher values at the inter-carpal joints. Overall, the inter-carpal joint demonstrated greater sensitivity than the other joints.
CONCLUSIONS: Ultrasound assessment of wrist joints should include intercarpal joints, as they frequently show increased power Doppler activity, indicating higher inflammatory activity. Key Points • The intercarpal joint is the most important component of the wrist for detecting ultrasound activity in clinical practice, particularly in patients with low disease activity in RA patients. • Musculoskeletal ultrasound (MSUS) assessment of disease activity may serve as a valuable tool for guiding therapeutic decisions within a treat-to-target strategy. Further studies are needed to optimize ultrasound evaluation and validate its measurements for clinical use.