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Soft-tissue changes in the hand in rheumatoid arthritis: evaluation with US
1Department of Diagnostic Radiology, University of Texas M.D. Anderson Cancer Center, Houston 77030.
Radiology
|December 1, 1989
Summary
High-frequency ultrasonography (US) accurately detects rheumatoid soft-tissue changes in the hand and wrist. This imaging technique is highly suggestive of rheumatoid tenosynovitis and provides a valuable preoperative map for surgeons.
Area of Science:
- Rheumatology
- Radiology
- Orthopedic Surgery
Background:
- Rheumatoid arthritis frequently affects soft tissues in the hand and wrist.
- Accurate diagnosis of tenosynovitis and tendon involvement is crucial for effective management.
Purpose of the Study:
- To evaluate the diagnostic accuracy of high-frequency ultrasonography (US) for rheumatoid soft-tissue involvement in the hand and wrist.
- To assess the correlation between US findings and surgical observations.
Main Methods:
- High-frequency (5.0 and 7.5 MHz) ultrasonography was performed on 16 patients with rheumatoid involvement.
- Surgical correlation was available for 11 of these patients.
- Real-time dynamic US examination was utilized.
Main Results:
- Hypoechoic thickening of tendon sheaths was observed in 94% of patients (mean 5.2 mm).
- US correctly identified flexor tendon ruptures in three patients.
- US findings correlated well with surgical findings in 10 of 11 patients.
Conclusions:
- Real-time high-frequency ultrasonography is highly accurate in detecting rheumatoid soft-tissue changes in the hand and wrist.
- A hypoechoic rim around tendons is highly suggestive of rheumatoid tenosynovitis.
- Ultrasonography provides surgeons with an accurate preoperative map of rheumatoid lesions.