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Roth J, Inbar-Feigenberg M, Raiman J, Bisch M, Chakraborty P, Mitchell J, Di Geso L. Ultrasound findings of finger, wrist and knee joints in Mucopolysaccharidosis Type I. Mol Genet Metab 2021; 133:289-296. [PMID: 34090760 DOI: 10.1016/j.ymgme.2021.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/19/2021] [Accepted: 05/25/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Musculoskeletal findings in MPS can progress after enzyme replacement. Our aim was to examine synovial recesses, tendons, retinacula and pulleys using ultrasonography for structural and inflammatory changes. MATERIAL AND METHODS The wrist, metacarpophalangeal (MCP), proximal and distal interphalangeal (PIP and DIP) joints, the finger flexor tendons and the knee including entheses of quadriceps and patella tendons were assessed clinically. Ultrasonography of the various synovial recesses of the wrist as well as the extensor retinaculum, carpal tunnel, MCP, PIP and DIP joints of the second finger, extensor and flexor tendons, A1-5 pulleys and the knee joint including relevant entheses followed. Significance of differences between patient values and available normative data were assessed using t-tests. RESULTS Ultrasonography showed significant abnormal intraarticular material in the wrist without a clear distribution to synovial recesses and without effusions. Doppler signals were found in a perisynovial distribution and not intrasynovial as expected in in inflammatory arthritis. Findings were similar in the knee but not the fingers. Flexor and extensor tendons were also mostly normal in their structure but significant thickening of retinaculae and the flexor tendon pulleys was seen (p<0.0001 compared to normal). CONCLUSION MPS I patients showed intraarticular deposition of abnormal material in the wrist and knee but not in the finger joints where significant thickening of retinaculae/pulleys controlling tendon position was dominant. No ultrasound findings of inflammatory pathology were demonstrated but rather a secondary reaction to abnormal deposition and direct damage of GAG.
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Affiliation(s)
- Johannes Roth
- Division of Pediatric Dermatology and Rheumatology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
| | - Michal Inbar-Feigenberg
- Division of Clinical and Metabolic Genetics, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Julian Raiman
- Department of Inherited Metabolic Disease, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, UK
| | - Marg Bisch
- Division of Pediatric Dermatology and Rheumatology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Pranesh Chakraborty
- Newborn Screening Ontario and Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - John Mitchell
- Department of Pediatrics, McGill University, Montreal, Quebec, Canada
| | - Luca Di Geso
- Ospedale Provinciale Madonna del Soccorso, Department of Internal Medicine, San Benedetto del Tronto, Marche, Italy
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Bruns A. Advances in Pediatric Musculoskeletal Ultrasonography. PEDIATRIC MUSCULOSKELETAL ULTRASONOGRAPHY 2020:351-360. [DOI: 10.1007/978-3-030-17824-6_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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Grassi W, Okano T, Di Geso L, Filippucci E. Imaging in rheumatoid arthritis: options, uses and optimization. Expert Rev Clin Immunol 2015; 11:1131-46. [DOI: 10.1586/1744666x.2015.1075395] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Zheng G, Wang L, Jia X, Li F, Yan Y, Yu Z, Li L, Wei Q, Zhang F. Application of high frequency color Doppler ultrasound in the monitoring of rheumatoid arthritis treatment. Exp Ther Med 2014; 8:1807-1812. [PMID: 25371736 PMCID: PMC4218660 DOI: 10.3892/etm.2014.2001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 08/29/2014] [Indexed: 12/18/2022] Open
Abstract
The aim of the present study was to explore the use of high frequency color Doppler ultrasound to measure synovial thickness and blood flow to assess the therapeutic value of the recombinant human tumor necrosis factor (TNF) II receptor antibody fusion protein in rheumatoid arthritis (RA) treatment. A total of 36 clinically-diagnosed patients with RA were treated with methotrexate tablets or the recombinant TNF-receptor antibody fusion protein for 24 weeks. Joint synovial thickness and synovial blood flow integrity were monitored by high frequency color Doppler in the second metacarpophalangeal joint in one hand. The correlation of the erythrocyte sedimentation rate, C-reactive protein (CRP) and 28-joint disease activity score (DAS28) with the ultrasound parameters were analyzed. Metacarpophalangeal second joint 2 (MCP2) synovial thickness, wrist joint synovial thickness and MCP2 synovial blood flow, prior and subsequent to the treatment, have a high correlation with DAS28 (P<0.05), and the MCP2 synovial blood flow integral has a strong correlation with CRP. Evaluating the wrist joint synovial thickness and synovial integrity of the second metacarpophalangeal joint using high frequency ultrasound detection can effectively evaluate the disease status in patients with RA. This procedure is potentially valuable as a means of evaluating the curative effects of RA treatments.
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Affiliation(s)
- Guimin Zheng
- Department of Rheumatology, Hebei Province General Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Lei Wang
- Department of Medicine Imaging, Hebei Province General Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Xiuchuan Jia
- Department of Medicine Imaging, Hebei Province General Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Fang Li
- Department of Rheumatology, Hebei Province General Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Yonglong Yan
- Department of Rheumatology, Hebei Province General Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Zhibo Yu
- Department of Rheumatology, Hebei Province General Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Li Li
- Department of Ultrasound Imaging, Hebei Province General Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Qun Wei
- Department of Nosocomial Infection Control, Hebei Province General Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Fengxiao Zhang
- Department of Rheumatology, Hebei Province General Hospital, Shijiazhuang, Hebei 050051, P.R. China
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Mérot O, Guillot P, Maugars Y, Le Goff B. Three-dimensional versus two-dimensional ultrasonographic assessment of peripheral enthesitis in spondylarthritis. Clin Rheumatol 2013; 33:131-5. [PMID: 24202615 DOI: 10.1007/s10067-013-2424-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 09/23/2013] [Accepted: 10/21/2013] [Indexed: 12/20/2022]
Abstract
To compare the intra- and interobserver reliability of three-dimensional (3D) volumetric versus conventional two-dimensional (2D) power Doppler ultrasonography (US) in the assessment of peripheral enthesitis in spondylarthritis (SpA). Sixteen patients with SpA according to ASAS criteria were included. Two rheumatologists (one experimented in musculoskeletal US (sonographer 1) and one beginner (sonographer 2)) performed independently a 2D US scoring of the enthesis using the Madrid Sonographic Enthesis Index score followed by a 3D acquisition of the same entheseal sites. The reading of the 3D acquisition was performed a minimum of 1 week apart. Intraobserver reliability was evaluated by a second reading of the same images. The duration of 2D US scanning, 3D US acquisition and reading was recorded. Intraclass correlation coefficients (ICCs) were used for the reliability analysis. Intraobserver reproducibility was good to excellent for 2D US and good for 3D US (ICC (95 %CI) 2D US 0.776 (0.471-0.916) and 0.96 (0.892-0.986) and ICC (95 %CI) 3D US 0.796 (0.498-0.921) and 0.703 (0.325-0.886) for sonographer 1 and 2, respectively). Interobserver reliability was slightly better for 3D US than for 2D US (ICC (95 %CI) 0.776 (0.471-0.916) for 3D US versus 0.641 (0.221-0.859) for 2D US). The mean time (±SD) for 2D US scanning was 23 min (±4) whereas the mean time for 3D US volume acquisition and reading was 16.5 min (±2.6) (p < 0.001). 3D US showed good intra- and interobserver reliability in the assessment of enthesitis in SpA and shortened the needed time for scanning. It can be performed by a nonexperienced examiner without loss of reliability.
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Affiliation(s)
- Oriane Mérot
- Rheumatology Unit, Hôtel-Dieu, Nantes University Hospital, 1 Place Alexis Ricordeau, 44095, Nantes, France
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Power Doppler ultrasonography for assessment of rheumatoid synovitis: comparison with dynamic magnetic resonance imaging. Clin Imaging 2012. [PMID: 23206619 DOI: 10.1016/j.clinimag.2012.02.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE The aim of this study was to compare the effectiveness of power Doppler ultrasonography (PDUS) with that of dynamic magnetic resonance imaging (MRI) for detecting active synovitis in the hands of rheumatoid arthritis (RA) patients. MATERIALS AND METHODS PDUS and dynamic MRI were performed for a total of 220 finger joints with active RA. Each synovial blood flow by PDUS and dynamic MRI was measured and categorized into four grades. RESULTS Taking dynamic MRI as a reference, PDUS showed a sensitivity of 94%, a specificity of 95%, and an accuracy of 95%. CONCLUSION PDUS is useful for detection of active synovitis in the overall-grade RA patients.
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High-Quality Intra-operative Ultrasound Reconstruction Based on Catheter Path. COMPUTER AIDED SURGERY 2012. [DOI: 10.1007/978-4-431-54094-6_13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Synovial and inflammatory diseases in childhood: role of new imaging modalities in the assessment of patients with juvenile idiopathic arthritis. Pediatr Radiol 2010; 40:985-98. [PMID: 20432018 DOI: 10.1007/s00247-010-1612-z] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2010] [Accepted: 02/06/2010] [Indexed: 10/19/2022]
Abstract
Juvenile idiopathic arthritis (JIA) represents a group of heterogeneous diseases characterized by a chronic inflammatory process primarily targeting the synovial membrane. A persistent synovitis is associated with an increased risk of osteocartilaginous damage.With the advent of effective structure-modifying treatment for JIA, it may be possible to significantly reduce or even completely prevent structural damage and associated functional disability. The trend towards early suppression of inflammation, in order to prevent erosive disease, shifts the emphasis away from conventional radiographic detectable structural damage to the slightest traces of early joint damage, and drives the need for alternative imaging techniques more sensitive in detecting early signs of disease activity and damage. In this regard MRI and US are playing an increasing role in the evaluation of arthritic joints.This article will review the key aspects of the current status and recent important advances of imaging techniques available to investigate the child with rheumatic disease, briefly discussing conventional radiography, and particularly focusing on MRI and US. In this era of advancing imaging technology, knowledge of the relative values of available imaging techniques is necessary to optimize the management of children with JIA.
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Detection of bone erosion in early rheumatoid arthritis: ultrasonography and conventional radiography versus non-contrast magnetic resonance imaging. Clin Rheumatol 2010; 29:883-91. [DOI: 10.1007/s10067-010-1423-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2009] [Revised: 02/06/2010] [Accepted: 02/22/2010] [Indexed: 10/19/2022]
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Kubassova O, Boesen M, Peloschek P, Langs G, Cimmino MA, Bliddal H, Torp-Pedersen S. Quantifying Disease Activity and Damage by Imaging in Rheumatoid Arthritis and Osteoarthritis. Ann N Y Acad Sci 2009; 1154:207-38. [DOI: 10.1111/j.1749-6632.2009.04392.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Østergaard M, Pedersen SJ, Døhn UM. Imaging in rheumatoid arthritis--status and recent advances for magnetic resonance imaging, ultrasonography, computed tomography and conventional radiography. Best Pract Res Clin Rheumatol 2009; 22:1019-44. [PMID: 19041075 DOI: 10.1016/j.berh.2008.09.014] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Sensitive and reproducible tools for diagnosis, monitoring of disease activity and damage, and prognostication are essential in the management of patients with rheumatoid arthritis (RA). Conventional radiography (X-ray), the traditional gold standard for imaging in RA, is not able to detect early disease manifestations such as inflammatory changes in the soft tissues (synovitis, tensynovitis, enthesitis etc.) and the earliest stages of bone erosion. In contrast, magnetic resonance imaging (MRI) and ultrasonography (US) allow direct visualization of early inflammatory and destructive joint changes, and have several documented and potential applications in RA patients. This chapter will review key aspects of the current status and recent important advances in imaging in RA, briefly discussing X-ray and computed tomography, and particularly focusing on MRI and US. Suggestions for use in clinical trials and practice are provided.
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Affiliation(s)
- Mikkel Østergaard
- Department of Rheumatology, Copenhagen University Hospitals at Herlev and Hvidovre, Copenhagen, Denmark.
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De Zordo T, Mlekusch SP, Feuchtner GM, Mur E, Schirmer M, Klauser AS. Value of contrast-enhanced ultrasound in rheumatoid arthritis. Eur J Radiol 2007; 64:222-30. [PMID: 17768022 DOI: 10.1016/j.ejrad.2007.07.011] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2007] [Accepted: 07/24/2007] [Indexed: 11/20/2022]
Abstract
The purpose of this review is to describe the spectrum of sonographic findings in rheumatic diseases with respect to the diagnostic potential using US contrast media which prove activity or inactivity in synovial tissue where new treatment regimes target. Synovial activity can be found in non-erosive and erosive forms of primary and secondary osteoarthritis, and in inflammatory forms of joint diseases like rheumatoid arthritis and peripheral manifestations of spondyloarthritis including, ankylosing spondylitis, Reiter's syndrome, psoriatic arthritis and enteropathic arthritis. It can also be present in metabolic and endocrine forms of arthritis, in connective tissue arthropathies like systemic lupus erythematosus or scleroderma and in infectious arthritis. Ultrasound should be used as first-line imaging modality in suspected early cases of RA and other forms of arthritis, whereas contrast-enhanced ultrasound (CEUS) can further enable for sensitive assessment of vascularity which correlates with disease activity.
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Affiliation(s)
- Tobias De Zordo
- Department of Radiology II, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria
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Calisir C, Murat Aynaci AI, Korkmaz C. The accuracy of magnetic resonance imaging of the hands and feet in the diagnosis of early rheumatoid arthritis. Joint Bone Spine 2007; 74:362-7. [PMID: 17602844 DOI: 10.1016/j.jbspin.2006.07.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2006] [Accepted: 07/05/2006] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To analyze MRI findings of early RA in the hand and foot joints and to determine any discrepancies between MRI findings in the hands and feet. METHODS Twenty one patients who fulfilled the 1987 American College of Rheumatology (ACR) criteria for the diagnosis of RA at the onset underwent MRI of both hands and feet. RESULTS In 18 out of 21 patients, rheumatoid changes were observed in the hand and foot joints. However, rheumatoid changes were observed only in the hand joints of the three remaining patients. MRI revealed pathologic findings suggested RA in the hands of 21 of 21 patients. In the feet, MRI findings suggested RA in 18 of 21 patients. Bone erosions were seen in the hands of 14 patients (67%). Observers found as many bony changes in the hands as in the foot joints. MRI detected active synovitis in 17 patients (81%) in the hands and in 15 patients (71%) in the feet. MRI findings suggested bone edema in the hand and foot joints in 14 (63%) and 11 patients (52%), respectively. There was no significant difference between the MCP and MTP joints with respect to RA-based changes obtained in the MRI (p>0.05). CONCLUSION Evidence of foot involvement is a frequent occurrence in early RA.
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Affiliation(s)
- Cuneyt Calisir
- Department of Radiology, Osmangazi University, Medical Faculty, Eskisehir, Turkey.
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Freeston J, Emery P. The role of MRI and ultrasound as surrogate markers of structural efficacy of treatments in rheumatoid arthritis. Joint Bone Spine 2007; 74:227-9. [PMID: 17383924 DOI: 10.1016/j.jbspin.2006.09.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2006] [Accepted: 09/18/2006] [Indexed: 10/23/2022]
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