Medical Radiology and Radiation Safety, 2016. Vol. 61. No. 2. P. 46-52
DIAGNOSTIC RADIOLODGY
N.V. Khabarina, E.V. Esin
Sonographic Syndromes of Osteochondral Changes of Medium and Small Joints of the Extremities with the Main Types of Arthropathy
Postgraduated Professional Education Institute of A.I. Burnasyan Federal Medical Biophisical Center, Moscow, Russia, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
ABSTRACT
Purpose: To determine the typical sonographic osteochondral manifestations of rheumatoid (ReA), reactive, gouty arthritis, osteoarthritis (OA), joint syndrome in systemic lupus erythematosus (SLE) and systemic sclerosis (SSc), psoriatic arthropathy (PsA) of the early pathological process, trace its dynamics.
Material and methods: Arthrosonography was made for 540 patients with articular syndrome in the expert class machines. The basic structure of the ultrasonic symptoms of hyaline cartilage and underlying bone, their changes are specific for each type of nosology.
Results: The Change in joint cartilage plates installed in 75.4 % of cases. Echographic pattern of pathology consisted of varying the thickness of the cartilage disk, its echogenicity, texture, contour, presence or absence of additional education in the projection of hyaline tissue. The lack of pathology of the articular cartilage was observed in patients with ReA acute course (n = 70), the debut of gout (n = 8), patients with a short period of the disease SLE, SSc and PsA (n = 19, 16, 69 respectively), in OA young people with the period of the disease is not more than 2 years (n = 52). Bone changes were presented in two versions: as a symptom of hardening layer subchondral bone (9.9 %), symptoms of marginal bone growths (5.2 %). The sensitivity of ultrasound as a whole was 84.4 %, specificity - 83.1 %, accuracy - 83.8 %.
Conclusions: An analysis of the dynamics of the ultrasound picture in rheumatoid and reactive arthritis, osteoarthritis, gout, psoriatic arthropathy and articular syndrome in systemic lupus erythematosus and systemic sclerosis was a direct correlation between the activity of the pathological process, the duration of the disease, its stage of radiological and ultrasound appearances. Erozirovanie articular cartilage may identify within 2.8 months after the occurrence of a destructive arthritis, degenerative changes and microcrystalline inclusions in the thickness of cartilage - after 6.1 months.
Key words: arthropathy, cartilage, bone structure of the joint, ultrasound diagnostics
REFERENCES
- Goncharov N.G. Sotsial'no-gigienicheskie aspekty invalidnosti, kliniko-funktsional'nye osobennosti. mediko-sotsial'naya ekspertiza i reabilitatsiya pri boleznyakh kostno-myshechnoi sistemy. Moscow. Avtoref. diss. dokt. med. nauk. 2001. 61 p. (In Russ.).
- Chichasova N.V., Mendel' O.I., Nasonov E.L. Osteoartroz kak obshcheterapevticheskaya problema. Russkii med. zhurnal. 2010. Vol. 18. No. 11(275). P. 729-734. (In Russ.).
- Nasonov E.L., Nasonova V.A. Revmatologiya: nauchnoe rukovodstvo. Moscow. GEOTAR-Media. 2008. 720 p. (In Russ.).
- Nasonov E.L. Vnedrenie vysokikh meditsinskikh tekhnologii v revmatologii: problemy i resheniya. Nauchno-praktich. revmatologiya. 2008. No. 2. P. 4-5. (In Russ.).
- Ivanova O.N., Sobolev Yu.A., Pyadova E.A. et al. Sravnitel'nyi analiz artrosonograficheskikh i rentgenologicheskikh izmenenii sustavov pri revmaticheskikh zabolevaniyakh. Nauchno-praktich. revmatologiya. 2013. No. 4. P. 11-15. (In Russ.).
- Babaev M.V., Volkov G.P. Sravnitel'naya otsenka rentgenograficheskoi i ul'trazvukovoi diagnostiki degenerativnykh porazhenii kolennogo sustava. Sb. nauch. rabot III Rossiisk. nauch. foruma «Luchevaya diagnostika i luchevaya terapiya v klinike XXI veka. Radiologiya 2002». Moscow. 2002. P. 17-18. (In Russ.).
- Karateev D.E., Aleksandrova E.N., Demidova N.V. et al. Antitsitrullinovye antitela i dannye magnitno-rezonansnoi tomografii sustavov kisti u bol'nykh rannim artritom. Ter. arkhiv. 2010. Vol. 80. No. 10. P. 72-77. (In Russ.).
- Bryukhanov A.V., Fedorov V.V., Mikhal'kov D.F. Magnitno-rezonansnaya tomografiya v diagnostike osteoartritov krupnykh sustavov. med. zhurnal. 1998. Vol. 13. No. 1-2. P. 28-30. (In Russ.).
- Sal'nikova T.S., Balabanova R.M. K voprosu o rannei diagnostike revmatoidnogo artrita. Nauchno-praktich. revmatologiya. 2009. No. 2. P. 7-10. (In Russ.).
- Backhaus M., Kamradt T., Sandrock D. et al. Arthritis of the finger joints: a comprehensive approach comparing conventional radiography. Scintigraphy, ultrasound and contrast-enhanced magnetic resonance imaging. Arthritis & Rheumatism. 2009. Vol. 42. P. 1232-1245.
- O’Connor P.J. US in early diagnosis and monitoring. ERR 2009. Book of Abstracts. Vienna. 2009. No. 19. Suppl. 1. P. 37.
- Bianchi S., Martinoli C., Damiani S., Derchi L.E. High frequency US of the hand and wrist. Eur. Radiol. 2009. Vol. 9. No. 6. P. 16-17.
- Cheremis N.A. Osobennosti diagnostiki revmatoidnogo artrita na rannei stadii. Moscow. Avtoref. dis. kand. med. nauk. 2005. 23 p. (In Russ.).
- Karateev D.E., Luchikhina E.L. Rannyaya diagnostika revmatoidnogo artrita: problemy i resheniya. Ross. med. vesti. 2013. No. 4. P. 24-27. (In Russ.).
- Ermak E.M., Kinzerskii A.Yu. Diagnostika rannikh stadii destruktsii sustavnogo khryashcha i ryada predartroznykh faktorov. Ul'trazvukovaya i funkts. diagnostika. 2002. No. 2. P. 297-298. (In Russ.).
- Goekoop-Ruiterman Y.P.M., de Vries-Bouwstra J.K., Allaart C.F. et al. Clinical and radiographic outcomes of four different treatment strategies in patients with early rheumatoid arthritis (the best study). Arthritis & Rheumatism. 2005. Vol. 11. P. 3381-3390.
- Kaposi P.N. The role of US angiography in rheumatological practice. Eur. 2009. Vol. 9. No. 6. P. 32-33.
- Olivieri I., Barozzi L., Peierro A. et al. Dactylitis in patients with seronegative spondylarthropathy: assessment by ultrasonography and magnetic resonance imaging. Arthritis & Rheumatism. 2006. Vol. 39. No. 9. P. 1524-1528.
- Ostergaard M., Ejbjerg B.J., Szkudlarek M. et al. Imaging in early rheumatoid arthritis: roles of magnetic resonance imaging. Ultrasonography, conventional radiography and computed tomography. Best Practice & Res. Clin. 2009. Vol. 19. No. 4. P. 91-116.
- Scheel A.K., Herman K.-G.A., Ohrndorf S. et al. Prospective 7 year follow up imaging study comparing radiography. Ultrasonography, magnetic resonance imaging in rheumatoid arthritis finger joints. Ann. Rheumatis Diseases. 2006. Vol. 65. No. 7. P. 595-600.
- Szkudlarek M., Klarlund M., Narvestad E. et al. Ultrasonography of the metacarpophalangeal and proximal interphalangeal joints in rheumatoid arthritis: a comparison with magnetic resonance imaging, conventional radiography and clinical examination. Arthritis Res. & Therapy. 2008. Vol. 143. No. 4. P. 572-579.
- Perova T.B., Zavadovskaya V.D., Ekimova L.S. Ekhograficheskie priznaki revmatoidnogo porazheniya kolennykh sustavov. Sb. mater. Nevskogo radiolog. foruma «Iz budushchego v nastoyashchee». Petersburg. 2003. P. 104-105. (In Russ.).
- Zavadovskaya V.D., Perova T.B., Khodashinskaya A.V., Saprykina E.V. Rol' ul'trazvukovogo issledovaniya v otsenke aktivnosti revmatoidnogo artrita. Vizualizatsiya v klinike. 2011. No. 17. P. 33-36. (In Russ.).
- Mach E.S., Pushkova O.V. Ul'trazvukovaya kharakteristika artrita kolennogo sustava pri revmaticheskikh boleznyakh. Vizualizatsiya v klinike. 2009. No. 19. P. 18-22. (In Russ.).
- Grassi W., Tittarelli E., Pirani O. et al. Ultrasound examination of metacarpophalangeal joints in rheumatoid arthritis. Scand. 2003. Vol. 22. No. 2. P. 243-247.
- Rusakova M.S., Gritsman N.N., Speranskii A.I., Mirzoeva S.M. Dannye immunomorfologicheskogo issledovaniya sustavnogo khryashcha pri revmatoidnom artrite. V sb. nauch. trudov: «Sovremennye problemy patogeneza i terapii revmaticheskikh zabolevanii». Riga. 1985. No. 15. P. 62-65. (In Russ.).
- Shostak N.A., Muradyants A.A., Loginova T.K., Timofeev V.T. Kliniko-immunologicheskie osobennosti rannego revmatoidnogo artrita. Nauchno-praktich. revmatologiya. 2011. No. 1. P. 15-17. (In Russ.).
- Harland U., Sattler H. Ultraschallfibel Orthopadie. Traumatologie. Rheumatologie. Berlin. Heidelberg. New York. London. Springer Verlag. 2001. 33 p.
- Erov N.K., Mairansaeva S.N. Voprosy diagnostiki mono- i oligoartritov razlichnoi etiologii. Voprosy revmatizma. 2012. No. 2. P. 41-44. (In Russ.).
- Alsaarela E., Suramo I., Tervonen O. Evaluation of humeral head erosion in rheumatoid arthritis: A comparison of ultrasonography. MRI, computed tomography and plain radiography. Brit. J. Rheumatol. 2008. Vol. 37. P. 1152-1156.
- Harris E.D. The bone and joint decade: a catalyst for progress. Arthritis & Rheumatism. 2011. Vol. 44. P. 1967-1970.
- Khanna D., Ranganath V.K., Fitzgerald J. et al. Increased radiographic damage scores at the onset of seropositive rheumatoid arthritis in older patients are associated with osteoarthritis of the hands, but not with rapid progression of damage. Arthritis & Rheumatism. 2008. Vol. 24. No. 5. P. 2284-2292.
- Dieppe P., Swan A. Identification of crystals in synovial fluid. Ann. Rheumatis Diseases. 2007. Vol. 58. P. 261-263.
- Mach E.S., Pushkova O.V., Severinova M.V. Porazhenie sustavov pri podagre (po dannym artrosonografii). V sb. mater. IV s"ezda Rossiiskoi assotsiatsii spetsialistov ul'trazvukovoi diagnostiki v meditsine. Moscow. 2003. P. 275. (In Russ.).
For citation: Khabarina NV, Esin EV. Sonographic Syndromes of Osteochondral Changes of Medium and Small Joints of the Extremities with the Main Types of Arthropathy. Medical Radiology and Radiation Safety. 2016;61(2):46-52. Russian.