Finger Joint Cartilage Evaluated by Semiquantitative Ultrasound Score in Patients With Rheumatoid Arthritis

Abstract

Objective Joint destruction in rheumatoid arthritis (RA) includes both bone and cartilage lesions. Since joint space narrowing (JSN) is not a direct evaluation of cartilage using radiography, we aimed to examine the validity of ultrasound (US) cartilage evaluation using a semiquantitative method in patients with RA. Methods We enrolled 103 patients with RA who were in remission or showing low disease activity and 42 healthy subjects. The cartilage thickness of the bilateral metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints of the second to fifth fingers was measured by US, and the recorded images were scored semiquantitatively using a scale of 0–2. In addition, the JSN of the corresponding joints was scored using a hand radiograph. The relationships between total cartilage thickness, its semiquantitative score, and JSN score were assessed using Spearman’s rank correlation coefficients. Results Total cartilage thickness was significantly thinner in patients with RA compared to healthy subjects for both the MCP and PIP joints (both P < 0.001). The semiquantitative sum of 16 joints ranged from 2 to 26 (median 8) in patients with RA, which was significantly greater than the 0–11 (median 4) in healthy subjects (P < 0.001). In patients with RA, the semiquantitative score showed a significant negative correlation with cartilage thickness (ρ = −0.64, P < 0.001) and a significant positive correlation with JSN score (ρ = 0.66, P < 0.001). Furthermore, these scores showed a significant correlation with RA disease duration. Conclusion A simplified and direct evaluation of finger joint cartilage damage by semiquantitative US score is valid and useful for patients with RA.

Evaluation of metacarpophalangeal joint cartilage thickness in patients with rheumatoid arthritis: a clinical and ultrasonographic study

“…Cartilage thickness measurement in clinical practice emerges as a time-consuming and laborious method. Assessment of the cartilage semi-quantitatively has been reported to be less time consuming and to have yielded similar results with the measurement of cartilage thickness (16). This findings have also been confirmed by our results.…”

Cartilage evaluation by ultrasonography in patients with rheumatoid arthritis: a scoping review

“…The metacarpophalangeal (MCP) joint was the most commonly assessed joint, with 16 (55%) studies assessing it [ 3 , 10 , 11 , 16 – 18 , 20 , 24 – 27 , 29 , 30 , 34 – 36 ]. Five studies assessed the proximal interphalangeal (PIP) joint [ 3 , 17 , 26 , 29 , 34 ].…”

“…The metacarpophalangeal (MCP) joint was the most commonly assessed joint, with 16 (55%) studies assessing it [ 3 , 10 , 11 , 16 – 18 , 20 , 24 – 27 , 29 , 30 , 34 – 36 ]. Five studies assessed the proximal interphalangeal (PIP) joint [ 3 , 17 , 26 , 29 , 34 ]. Two studies also assessed the wrist but only described observations from the dorsal aspect; moreover, it was unclear which wrist cartilage was assessed [ 20 , 26 ].…”

The Reliability of Ultrasound in the Assessment of Hyaline Cartilage in Rheumatoid Arthritis and Healthy Metacarpal Heads

“…US scanning was performed using a MyLab Twice (Esaote, Genoa, Italy), equipped with a very high frequency broadband linear probe (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Gray scale setting parameters were standardized as follows: B-mode frequency: 22 MHz, master gain: 70 %, mechanical index: 0.3, dynamic range: 12, depth 15 mm, focus position at the area of interest.…”

“…Nevertheless, only a few studies have investigated the validity of US in the assessment of hyaline cartilage at the metacarpal head level in RA [11][12][13][14][15][16]. Moreover, several discrepancies in the US methods to scan and interpret cartilage involvement have been described [17].…”