Evaluation of hand and wrist joints using ultrasonography and doppler in patients of Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by joint inflammation and systemic involvement. The management of RA has evolved over the years, with early diagnosis and rapid achievement of remission being the primary goals. In this prospective observational study conducted at the Department of Radio-diagnosis, Baroda Medical College and Hospitals, Vadodara, Gujarat, we aimed to evaluate the pathological involvement of hand and wrist joints in patients with rheumatoid arthritis using ultrasonography (USG) and color Doppler. A total of 32 diagnosed RA patients were included, and their clinico-pathological scores were assessed. The most common ultrasonographic finding in the examined wrist joints was joint synovitis, with the radio-carpal joint being the most frequently involved. Among the small joints of the hand, synovitis and erosions were commonly observed, with the second metacarpophalangeal joint showing the highest involvement. Comparison with clinical disease activity using the Disease Activity Score 28 (DAS-28) revealed that patients with higher DAS-28 scores had a higher incidence of pathological changes in hand and wrist joints on USG. The use of power Doppler ultrasound allowed for the monitoring of disease activity, with increased doppler signals observed in joints of patients with high disease activity. These findings were consistent with previous studies showing correlations between DAS-28 scores and ultrasound findings. Ultrasonography and color Doppler proved to be reliable tools for visualizing pathological processes in RA patients, with synovitis grading and power Doppler grading demonstrating good correlations with disease activity. In conclusion, ultrasonography and color Doppler can be valuable in assessing and monitoring rheumatoid arthritis, enabling early detection and accurate evaluation of joint involvement.