Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement
The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.
Grey-Scale and Power Doppler Sonographic Findings in Patients with Erosive Osteoarthritis of the Interphalangeal Joints as Compared with Patients with Non-Erosive Osteoarthritis
Wittoek1, Ruth, Carron1, Philippe, Verbruggen2, Gust
To compare sonographic findings in patients with erosive osteoarthritis (OA) of the Interphalangeal (IP) finger joints and non-erosive OA of the IP joints, in order to evaluate the diagnostic value of ultrasound in distinguishing between erosive and non-erosive OA of the IP joints.
A total of 310 proximal IP (PIP) and 248 distal IP (DIP) joints of 31 patients with radiographic erosive OA of the IP joints and 70 PIP and 56 DIP joints of 7 patients with non-erosive IP OA were examined by ultrasound using dorsal longitudinal and transverse scanning. One experienced examiner (RW) performed the scans using a MyLab 25 (Esaote, Italy) machine with a 1018 MHz linear array transducer. Both Grey-scale and power Doppler (PD) sonography were performed. Representative images were digitally scored and were read under blinded conditions. Presence of effusion, synovitis, osteophytes, cartilage and PD signals intracapsular were scored in a dichotomous way (absent/present).The images of ten patients were reread by another investigator (PC), blinded for all clinical data, allowing to calculate the interobserver reliability by Kappa statistics (k).
Bone erosions, identified by a bone cortex discontinuation in the area adjacent to the joints, visualized in two perpendicular planes, were observed in 20.3% of joints of patients with erosive OA compared to 4.8% of joints of patients with non-erosive OA (p < 0.01). Remarkably more erosions were identified in the DIP than in the PIP joints (26.2% vs. 15.5%, p < 0.05) in the erosive OA group. Bone proliferations or osteophytes were seen in 55.9% and 58.7% of joints respectively, in patients with erosive and non-erosive OA. Effusion, represented by an anechoic signal in the joint space, different from cartilage, was found in 45.3 % of the erosive and 48.4% of the joints of patients with non-erosive OA. Grey-scale synovitis, represented by an anechoic or hypoechoic signal in the intracapsular area, was present in respectively 16.3% and 12.7% of the joints in patients with erosive and non-erosive OA. No difference in PD signals were localized in the intracapsular area of the joints of patients with erosive and non-erosive OA (2.2% and 0.7% of joints, respectively).
Interobserver reliability was very good for all parameters (k= 0.91 for erosions, k= 98 for osteophytes, k= 0.98 for hydrops, k= 0.99 for synovitis, and k= 0.94 for PD signal).
Ultrasound seems to be able to differentiate between erosive and non-erosive OA of the IP joints by identifying more erosions in the erosive form. Presence of osteophytes, effusion, synovitis and PD signals are comparable in both diseases.
To cite this abstract, please use the following information:
Wittoek, Ruth, Carron, Philippe, Verbruggen, Gust; Grey-Scale and Power Doppler Sonographic Findings in Patients with Erosive Osteoarthritis of the Interphalangeal Joints as Compared with Patients with Non-Erosive Osteoarthritis [abstract]. Arthritis Rheum 2009;60 Suppl 10 :197