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SHR Neuro Krebs Kardio Lipid

Husic, R; Lackner, A; Stradner, MH; Hermann, J; Dejaco, C.
Joint positions matter for ultrasound examination of RA patients-increased power Doppler signal in neutral versus flat position of hands
RHEUMATOLOGY. 2017; 56(8): 1312-1319.
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Abstract:
Objective. Position of joints might influence the result of US examination in patients with RA. The purpose of this work was to compare grey-scale (GS) and power Doppler (PWD) findings obtained in neutral vs flat position of hands. Methods. A cross-sectional study of 42 RA patients with active disease. Two dimensional and 3D sonography of wrists and MCP joints were conducted in two different joint positions: neutral position, which is a slight flexion of the fingers with relaxed extensor muscles; and flat position, where all palm and volar sides of fingers touch the Table. Two dimensional GS synovitis (GSS) and PWD signals were scored semi-quantitatively (0-3). For 3D sonography, the percentage of PWD voxels within a region of interest was calculated. GSS was not quantified using 3D sonography. Results. Compared with neutral position, 2D PWD signals disappeared in 28.3% of joints upon flattening. The median global 2D PWD score (sum of all PWD scores of an individual patient) decreased from 8 to 3 (P<0.001), and the global 3D PWD voxel score from 3.8 to 0.9 (P<0.001). The reduction of PWD scores was similar in all joints (2D: minus 50%, 3D: minus 66.4-80.1%). Inter- and intrareader agreement of PWD results was good (intraclass correlation coefficient: 0.75-0.82). Conclusion. In RA, a neutral position of the hands is linked to a higher sensitivity of 2D and 3D sonography in detecting PWD signals at wrists and MCP joints, compared with a flat position. Standardization of the scanning routines.

Find related publications in this database (Keywords)
rheumatoid arthritis
hand
diagnostic imaging
ultrasonography
wrist
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