ab22608

Ultrasonography detection of early bone erosions in the metacarpophalangeal joints of patients with rheumatoid arthritis

M. Magnani¹, E. Salizzoni², R. Mulè³, M. Fusconi⁴, R. Meliconi^3,4, S. Galletti¹

¹Ultrasonology Unit, Istituti Ortopedici Rizzoli; ²Department of Radiologic and Histocytopathological Sciences, Policlinico S. Orsola-Malpighi; ³Rheumatology Unit, Istituti Ortopedici Rizzoli; ⁴Department of Internal Medicine, Cardioangiology, Hepathology, Policlinico S. Orsola-Malpighi, Bologna, Italy.

ABSTRACT
Objective
To compare ultrasonography (US) and magnetic resonance imaging (MRI) in their capability to detect bone erosions in early-advanced rheumatoid arthritis, where no erosion was evident on conventional radiography (X-ray).

Methods
Metacarpophalangeal (MCP), radiocarpal and ulnocarpal joints of 13 patients with rheumatoid arthritis, with bone erosion that was not detected by conventional X-ray, were examined by US and MRI. Ten controls underwent examination of the same joints by US.

Results
None of the controls showed bone erosions at US examination. No significant difference between US and MRI in detecting bone erosion was observed in wrist joints, whereas a significantly higher number of erosions was detected by US in MCP joints.

Conclusion
US is at least as sensitive as MRI in detecting bone erosions in MCP and wrist joints. Since US examination is a more easily available and less expensive procedure than MRI, our findings justify its use as a diagnostic tool for early arthritis. In addition US may also be utilized in the follow up of patients with an established diagnosis of inflammatory arthritis.

Key words
Bone erosions, rheumatoid arthritis, ultrasonography, magnetic resonance imaging.

Please address corrrespondance and reprint requests to: R. Meliconi, MD, Rheumatology Unit, Istituto Ortopedico Rizzoli, Via Pupilli no. 1, 40136 Bologna, Italy.
E-mail: riccardo.meliconi@unibo.it