Dark-lumen MR colonography is a feasible and useful method of evaluating the entire colon in patients with incomplete conventional colonoscopy.

Background The detection of joint swelling caused by synovitis is important for the diagnosis of inflammatory arthritis. Ultrasound (US) and MRI have proven to be more sensitive and reliable than physical examination, but they are time-consuming and expensive. The automated breast volume scanner was developed to acquire serial B-mode pictures of the female breast and these can be analyzed in all three dimensions. Objectives To analyze the value of automated B-mode ultrasound employing the ABVS system in detecting synovitis of the finger joints compared to manual ultrasound (mUS) and physical examination, using MRI as the gold standard. Methods 19 consecutive patients suffering from active rheumatoid (n=15) or psoriatic (n=4) arthritis were included. Automated and mUS were conducted with a linear array (ACUSON S2000™, 11 MHz). Multiplanar reconstruction enabled examination of the images for the presence of synovitis. Results 90% of the hand joints were assessable by automated ultrasound. Automated US detected 12.0, mUS 14.2, MRI 13.4, and clinical examination 4.1 positive joints – i. e. joints with synovitis - on average per patient. The inter-observer reliability of both assessors for automated and mUS, MRI, and physical examination, was 66.9%, 72.7%, 95.1%, and 88.9%, respectively. 84.3% of the joints classified as positive on MRI were confirmed by automated ultrasound, 85.5% on mUS, and 36.0 on physical examination. This translated into a sensitivity of 83.5%, 85.5%, and 36.0% for the three methods, respectively. Conclusion: Automated ultrasound is a promising ultrasound method for assessing small joints in patients with inflammatory arthritis.

Background The detection of joint swelling is a key feature in the diagnosis and assessment of arthritic diseases. Ultrasound and MRI have proven to be more sensitive and reliable than clinical examination, but a comprehensive examination of the small joints with these techniques is either time consuming or expensive. The automated breast volume scanner (ABVS) was developed to acquire series of consecutive B-mode pictures of the female breast and these data can be analysed in all three dimensions. Objectives To analyse the value of ABVS in detecting swelling of the finger joints compared to clinical examination and manual ultrasound. Methods 19 consecutive patients suffering from psoriatic (n=4) or rheumatoid (n=15) arthritis with at least 1 swollen MCP (metacarpophalangeal) or PIP (proximal interphalangeal) joint were included. ABVS and manual ultrasound were conducted using the ACUSON S2000™ (Siemens Medical Solutions, Mountain View, USA). The ABVS transducer was equipped with a linear array (5 – 14 MHz band width); the frequency was set at 11 MHz. Each automatic sweep of the scanner generated 15.4 x 16.8 cm x maximum 3 cm volume data sets. The system was set to perform an automatic scanning time of 65 s per scan with a slice thickness of 0.5 mm. The dorsal and palmar side of each hand were scanned separately. Multiplanar reconstruction enabled examination of the images at multiple levels for the presence of lesions or joint swelling (figure) Results Clinical examination of MCP, PIP, and DIP joints detected in average 4.1 swollen joints, manual ultrasound 13.7 joints, and ABVS 10.6 joints per patient. The interobserver reliability for detection of joint swelling were 73.3%, 72.5% and 85.9% for manual ultrasound, ABVS, and clinical examination, respectively. The sensitivities and specificities were 30.7% and 91.3% for clinical examination and 59.9% and 63.4% for ABVS using manual ultrasound as gold standard. Image/graph Conclusions ABVS is a simple and time sparing option for effective detection of joint swelling in patients suffering from arthritis with good sensitivity and specificity compared to manual ultrasound. Disclosure of Interest None Declared

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