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2012 ; 12
(50
): 319-28
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The pathogenesis of rheumatoid arthritis in radiological studies Part II:
Imaging studies in rheumatoid arthritis
#MMPMID26673409
Sudo?-Szopi?ska I
; Zaniewicz-Kaniewska K
; Warczy?ska A
; Matuszewska G
; Saied F
; Kunisz W
J Ultrason
2012[Sep]; 12
(50
): 319-28
PMID26673409
show ga
Early diagnosis of rheumatoid arthritis followed by early initiation of
treatment, prevent the destruction of joints and progression to disability in the
majority of patients. A traditional X-ray fails to capture early inflammatory
changes, while late changes (e.g. erosions) appear after a significant delay,
once 20-30% of bone mass has been lost. Sonography and magnetic resonance imaging
studies have shown that erosions are seen in the first 3 months from the
appearance of symptoms in 10-26% of patients, while in 75% they are seen in the
first 2 years of the disease. Power Doppler ultrasound and dynamic magnetic
resonance studies allow for qualitative, semiquantitative and quantitative
monitoring of the vascularization of the synovium. In addition, magnetic
resonance enables assessment of the bone marrow. The ultrasonographic examination
using a state-of-the-art apparatus with a high-frequency probe allows for images
with great spatial resolution and for the visualization of soft tissues and bone
surfaces. However, the changes seen in ultrasonography (synovial pathologies, the
presence of exudate, tendons changes, cartilage and bone lesions, pathologies of
tendon attachments and ligaments - enthesopathies) are not only specific for
rheumatoid arthritis and occur in other rheumatic diseases. Qualitative methods
are sufficient for diagnosing the disease through ultrasound or magnetic
resonance imaging. Whereas semiquantitative and quantitative scales serve to
monitor the disease course - efficacy of conservative treatment and qualification
for radioisotope synovectomy or surgical synovectomy - and to assess treatment
efficacy.
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