Joint swelling in the hand in rheumatoid arthritis: agreement between clinical evaluation, ultrasonography, magnetic resonance imaging and patient self-evaluation.

OBJECTIVE

To describe agreement in detection of joint swelling as the mandatory key of the diagnostic algorithm used in rheumatoid arthritis (RA). This was done by comparing clinical examinations, ultrasonography (US), Magnetic Resonance Imaging (MRI) and patient self-evaluation of the joints in the wrist and fingers (metacarpophalangeal joints (MCP) and proximal interphalangeal joints (PIP)) in an early untreated RA cohort.

METHODS

14 patients (8 women and 6 men, mean age ± standard deviation: 54.9 ± 14.5 years, range: 34-81 years) with symptom duration of less than six months, steroid and DMARD naïve at the time of examination and no previous history of arthritis were included in the study. US techniques included B mode and Color Doppler while MRI included a variety of imaging sequences (STIR, T1W TSE and T1W VIBE).

RESULTS

Overall, there was good agreement between clinical evaluation, evaluation by US, by MRI or patients' own evaluation of joint swelling. Patient self-evaluation converged with the clinical evaluation in 12 cases (86%).

CONCLUSION

Agreement was good among the applied imaging modalities and patient self-evaluation when compared to the clinical evaluations. Adding MRI to the US examination did not provide further diagnostic information.