Vol.19 No.5

Original Article

Screening for rheumatoid arthritis with finger joint power Doppler ultrasonography: quantification of conventional power Doppler ultrasonographic scoring

Authors

Jun Fukae1 , Masato Shimizu1 , Yujiro Kon1 , Kazuhide Tanimura1 , Megumi Matsuhashi1 , Tamotsu Kamishima2 , Takao Koike3

  • Center for Rheumatic Diseases, Tokeidai Memorial Hospital, Sapporo, Hokkaido, Japan
  • Department of Radiology, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
  • Department of Medicine II, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo Hokkaido, 060-8638, Japan
Received:

9 March 2009

Accepted:

19 May 2009

Published online:

18 June 2009

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Abstract

Power Doppler ultrasonography (PD-US) has proved to be a useful technique to measure synovial vascularity due to its capability to provide data that can be used to evaluate the level of joint inflammation and assess rheumatoid arthritis (RA). We have developed a novel PD-US finger joint scoring method that introduces quantitative measurements into the conventional PD-US assessment method. A comparison of the two methods revealed that our novel PD-US method strongly correlates with the conventional method in terms of RA assessment. We performed finger joint PD-US on 69 patients with RA and 70 patients who had multiple joint pain but showed no evidence of inflammatory diseases (non-inflammatory disease, NI) and measured the synovial vascularity of the metacarpophalangeal joints 1?5 and proximal interphalangeal (PIP) joints 1?5 for each patient. We analyzed the data with receiver operating characteristic analysis and, based on the results for the total vascularity of 20 finger joints, defined a cut-off value of 36% as discriminating between RA and NI. This cut-off value was found to be a valuable tool in screening for RA. We conclude that our finger joint PD-US scoring system is both useful and applicable for diagnosing RA.

Key words

Diagnosis - Power Doppler ultrasonography - Quantitative scoring method - Rheumatoid arthritis - Synovial vascularity