Breaking News
April 23, 2018 - Study uncovers possible source of gender differences in migraines
April 23, 2018 - Study proves usefulness of EDX testing in diagnosis, management of neuromuscular disorders
April 23, 2018 - Eating fish could prevent Parkinson’s disease
April 23, 2018 - Key factor in development of Parkinson’s disease identified
April 23, 2018 - Higher consumption of fish linked to better neurological health
April 23, 2018 - Genevac announces HT Series 3 evaporators with Inert Gas Purge option
April 23, 2018 - Researchers clarify immune response for patients with breast cancer brain metastases
April 23, 2018 - Polypharmacy More Likely for Cancer Survivors
April 23, 2018 - Obesity is shifting cancer to young adults
April 23, 2018 - Scientists illustrate role of novel chromosomal mutations in fosfomycin resistance
April 23, 2018 - Newly developed drug compound may help treat Charcot-Marie-Tooth disease
April 23, 2018 - Marriage Means ‘I Do’ for Skin Cancer Detection
April 23, 2018 - Freezing hunger-signaling nerve may help ignite weight loss
April 23, 2018 - Wear exoskeletons with caution for heavy lifting, researchers say
April 23, 2018 - Research offers new hope for healing wounds in patients with diabetes
April 23, 2018 - Shorter courses of radiotherapy found to be safe, effective for prostate cancer patients
April 23, 2018 - Scientists use CRISPR tool to make multiple edits to DNA samples ‘in vitro’
April 23, 2018 - Knee reconstructions are on the rise among the youth in Australia
April 23, 2018 - Artificial sweeteners linked to obesity warn researchers
April 23, 2018 - CDC seeking $400 million to replace lab for deadliest germs
April 23, 2018 - Sensirion to present single-use liquid flow sensor at COMPAMED 2017
April 23, 2018 - FDA approves contact lenses that shade the sun
April 22, 2018 - Concussion recovery and symptom severity found to vary between men and women
April 22, 2018 - C. Difficile Risk Higher With Stoma Reversal Versus Colectomy
April 22, 2018 - Repeated ranibizumab doesn’t impair macular perfusion
April 22, 2018 - New microscope reveals how cells behave in 3D and real time inside living organisms
April 22, 2018 - Study shows clinical benefit and monetary gains of weight-loss surgery
April 22, 2018 - GNA Biosolutions launches world’s first Laser PCR platform at Medica Trade Fair
April 22, 2018 - Researchers present simulation model to investigate hospital responsiveness to mass casualty incidents
April 22, 2018 - Does Pot Really Dull a Teen’s Brain?
April 22, 2018 - Controversial pregnancy test drug shows deformities in zebrafish embryos within hours of exposure
April 22, 2018 - New research partnership makes childbirth safer in Mozambique
April 22, 2018 - Brief bedside visual art intervention reduces pain, anxiety in cancer patients
April 22, 2018 - The memory part of the brain may also hold clues for anxiety and depression
April 22, 2018 - AYOXXA to develop multiplex immunoassay to support treatment of sepsis patients
April 22, 2018 - New Drug Combo Ups Survival in HER2/neu Uterine Serous Cancer
April 22, 2018 - Researchers chart a new way to look at concussion
April 22, 2018 - Every parent needs to know fundamental red flags for autism
April 22, 2018 - Anatotemp expands anatomic dental implant healing abutments with 4Side anti-rotational connection
April 22, 2018 - Gene Twist Can Make Your Blood Pressure Spike From Salt
April 22, 2018 - Study suggests failed osteoarthritis drug could help treat opioid addiction
April 22, 2018 - More Americans aware of growing problem of opioid addiction
April 22, 2018 - KHN’s ‘What the Health?’ Nothing in health care ever goes away
April 22, 2018 - BGS to promote high-quality sterilization services at Health GB in Manchester
April 22, 2018 - New integrated POC tool detects biomarkers of heart failure rapidly and precisely
April 22, 2018 - Direct electrical current can be delivered to nerves for blocking pain signals
April 22, 2018 - Newly Published Phase 2 Study Found Esketamine Demonstrated Significantly Rapid Improvements in Depressive Symptoms and Suicidality
April 22, 2018 - Healthy red blood cells owe their shape to muscle-like structures
April 22, 2018 - Researchers present case study of management of rheumatic mitral regurgitation in woman contemplating pregnancy
April 22, 2018 - New black Porvair Krystal UV Quartz microplates for Circular Dichroism measurements
April 22, 2018 - Advanced flow chemistry modules enhance control of nanoprecipitation
April 22, 2018 - Look! Down in the petri dish! It’s a superplatelet!
April 22, 2018 - Research reveals why people with tetraplegia more likely to suffer from sleep apnea
April 21, 2018 - New non-invasive nerve stimulation may offer relief for people with hand tremor
April 21, 2018 - Smartphone App May Up Medication Adherence in HTN
April 21, 2018 - Western diet depletes artery-protecting immune cells
April 21, 2018 - Excelitas Technologies launches new powerful LED light source for fluorescence microscopy
April 21, 2018 - Academia and high tech companies join forces to increase production capacity for microfluidic systems
April 21, 2018 - Developing cooking skills as young adult may have long-term health benefits
April 21, 2018 - Study compares survival outcomes of different drugs for type 2 diabetes
April 21, 2018 - More Than 40 Percent of Americans Breathe Dirty Air: Report
April 21, 2018 - Obstructive sleep apnea – Genetics Home Reference
April 21, 2018 - More evidence shows exposure to traffic and outdoor air pollution increases risk of asthma
April 21, 2018 - Novel gold nanoparticle technology could guide cancer treatment in real-time
April 21, 2018 - News coverage of Ebola impacted public’s perception on disease and survivors
April 21, 2018 - S.Africa’s DIY battle against HIV
April 21, 2018 - Children with autism have gastrointestinal and immune system deregulation, research finds
April 21, 2018 - Human brain processes sight and sound in the same way, shows study
April 21, 2018 - Evolutionary history of tumor helps predict severity of prostate cancer
April 21, 2018 - Pepper plant metabolizes antibiotic in personal care products
April 21, 2018 - Tradeshow Talks with Integra
April 21, 2018 - EPFL becomes part of Chan Zuckerberg’s project to develop Human Cell Atlas
April 21, 2018 - Pfizer Announces Positive Topline Results From Phase 3 ATTR-ACT Study Of Tafamidis In Patients With Transthyretin Cardiomyopathy
April 21, 2018 - Breaking through the HIV vaccine ‘logjam’
April 21, 2018 - IntelliCyt introduces new QSol buffer to enable robust, consistent sampling
April 21, 2018 - Scientists publish comprehensive lineage tree of whole adult animal in Science journal
April 21, 2018 - Innovative method based on FluidFM technology could revolutionize biological research
April 21, 2018 - Americans world’s biggest TV addicts, watching four hours a day
April 21, 2018 - Investigational drug may help increase protein levels in babies with spinal muscular atrophy
April 21, 2018 - Study shows distinctions between age groups in predicting and responding to stress at home
Ultrasound vs MRI in Rheumatoid Arthritis

Ultrasound vs MRI in Rheumatoid Arthritis

image_pdfDownload PDFimage_print

Early recognition and treatment of rheumatoid arthritis (RA) led to reduced inflammation and less joint damage, which results in better long-term outcomes. With current treat-to-target guidelines, it is helpful to have reliable, reproducible diagnostic tools to discover and then monitor treatment for RA.

Japanese researchers pointed out that recent advances have led to the rise of ultrasound and MRI modalities as the tools of choice for diagnosis and monitoring disease activity in patients with RA. “The presence of inflammation observed with US or MRI can be used to predict the progression from undifferentiated inflammatory arthritis to clinical RA,” they noted.

The group sought to compare the accuracy of ultrasound with that of MRI for detecting synovitis in patients with RA. They conducted a systematic review and meta-analysis of the available literature. The primary outcomes were diagnostic test accuracy of ultrasound for synovitis with MRI as the standard.

Ultimately, 14 studies were included in the final analysis. Wrists, metacarpal phalangeal joints (MCP), and proximal interphalangeal (PIP) joints were evaluated separately.

The Results

  • Wrist joint cohorts yielded an ultrasound diagnostic odds ratio (DOR) of 11.6 and an area under the curve (AUC) of 0.81, which suggest good diagnostic test accuracy for synovitis.
  • Sensitivity and specificity for wrist ultrasound were 0.73 and 0.78, respectively.
  • MCP cohorts yielded an ultrasound DOR of 28 and an AUC of 0.91, which suggest good diagnostic test accuracy for synovitis.
  • Sensitivity and specificity for MCP joint ultrasound were 0.64 and 0.93, respectively.
  • PIP cohorts yielded an ultrasound DOR of 23 and an AUC of 0.91, which suggest good diagnostic test accuracy for synovitis.
  • Sensitivity and specificity for PIP joint ultrasound were 0.71 and 0.94, respectively.
  • Knee joint cohorts yielded an ultrasound DOR of 5.3 and an AUC of 0.61, which suggest poor diagnostic test accuracy for synovitis.
  • Sensitivity and specificity for knee joint ultrasound reflected no diagnostic value in the test.

Implications

  • Ultrasound is an inexpensive, reproducible, and accurate diagnostic tool for synovitis in patients with RA, especially when examining the MCP and PIP joints.
  • Ultrasound is probably not the diagnostic modality of choice for knee synovitis.
  • Ultrasound is a good option for point of care diagnosis of synovitis in patients with RA in the outpatient setting.
  • Power Doppler ultrasound showed better diagnostic test accuracy than greyscale ultrasound.

Key points

  • Ultrasound is accurate in detecting synovitis, especially at the metacarpal phalangeal joints and the proximal interphalangeal joints.
  • While more sensitive than clinical examination, ultrasound is less sensitive than MRI for deeper joints such as the wrist and the knee joints.
  • There is a lack of consensus regarding a standardized ultrasound scoring system for synovitis.
  • Compared with MRI, ultrasound is less expensive and more portable and has fewer contraindications.

This article originally appeared on our partner’s website Rheumatology Network, which is a part of UBM Medica. (Free registration is required.)

2018-01-20T16:00:00-0500

Tagged with:

About author

Related Articles