[Ultrasonography in the joints of hands with rheumatoid arthritis]

The findings of preoperative ultrasonography (US) in 37 joints of 12 patients with rheumatoid arthritis (RA) were evaluated and compared with clinical staging and operative findings. By US, synovial proliferation in the joints was observed as hypoechoic solid tumor. By dynamic examination of the metacarpophalangeal (MP) joints, the developmental process of joint immobilization could be detected through a close study of the relationship between the proliferated synovium and extensor tendons, synovial bursa, sagittal bands, and expansion hoods. As the cartilage and heads of the metacarpal bones and proximal phalanges could be demonstrated by dorsal scanning of the articular space of the over-flexed MP and proximal interphalangeal (PIP) joints, small synovial proliferation and irregular border of the cartilage could be detected during the early stage of inflammation. The findings of the present study showed that the application of preoperative US to RA patients was very useful for early diagnosis and for the selection of treatment, including operative methods.