Ultrasonographic imaging of the hand and wrist in rheumatoid arthritis

Objective To assess ultrasound findings in patients with rheumatoid arthritis affecting the hand and wrist compared to normal volunteers. Design Metacarpophalangeal and carpal articulations were imaged ultrasonically. Two readers reviewed static images for synovial, cartilaginous, and bony abnormalities using severity and probability scales. Ultrasound findings were correlated with disease activity. Patients Ten normal volunteers and 29 patients with known rheumatoid arthritis. Results Synovial abnormalities and erosions were most commonly identified in the rheumatoid hand and wrist (p<0.01). Criteria used for normal and abnormal cartilage did not predict normal and disease states. Significant differences in synovial abnormalities and erosions were observed between the inactive and mildly active disease groups as well as the active and mildly active disease groups (p<0.01). Conclusion Ultrasound can detect abnormalities of the hand and wrist in patients with rheumatoid arthritis compared to normal volunteers. Normal articular anatomy is well demonstrated ultrasonically.