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Ultrasound Versus Contrast-Enhanced Magnetic Resonance Imaging for Subclinical Synovitis and Tenosynovitis: A Diagnostic Performance Study

OBJECTIVES: Radiographic manifestations of synovitis (e.g., erosions) can be observed only in the late stage of rheumatoid arthritis. Ultrasound is a noninvasive, cheap, and widely available technique that enables the evaluation of inflammatory changes in the peripheral joint. In the same way, dynam...

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Autores principales: Bao, Zhongtao, Zhao, Yanchun, Chen, Shuqiang, Chen, Xiaoyu, Xu, Xiang, Wei, Linglin, Xiong, Meilian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Faculdade de Medicina / USP 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6963161/
https://www.ncbi.nlm.nih.gov/pubmed/31967284
http://dx.doi.org/10.6061/clinics/2020/e1500
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author Bao, Zhongtao
Zhao, Yanchun
Chen, Shuqiang
Chen, Xiaoyu
Xu, Xiang
Wei, Linglin
Xiong, Meilian
author_facet Bao, Zhongtao
Zhao, Yanchun
Chen, Shuqiang
Chen, Xiaoyu
Xu, Xiang
Wei, Linglin
Xiong, Meilian
author_sort Bao, Zhongtao
collection PubMed
description OBJECTIVES: Radiographic manifestations of synovitis (e.g., erosions) can be observed only in the late stage of rheumatoid arthritis. Ultrasound is a noninvasive, cheap, and widely available technique that enables the evaluation of inflammatory changes in the peripheral joint. In the same way, dynamic contrast-enhanced magnetic resonance imaging (MRI) enables qualitative and quantitative measurements. The objectives of the study were to compare the sensitivity and accuracy of ultrasound in detecting subclinical synovitis and tenosynovitis with those of contrast-enhanced MRI. METHODS: The ultrasonography and contrast-enhanced MRI findings of the wrist, metacarpophalangeal, and proximal interphalangeal joints (n=450) of 75 patients with a history of joint pain and morning stiffness between 6 weeks and 2 years were reviewed. The benefits score was evaluated for each modality. RESULTS: The ultrasonic findings showed inflammation in 346 (77%) joints, while contrast-enhanced MRI found signs of early rheumatoid arthritis in 372 (83%) joints. The sensitivities of ultrasound and contrast-enhanced MRI were 0.795 and 0.855, respectively, and the accuracies were 0.769 and 0.823, respectively. Contrast-enhanced MRI had a likelihood of 0-0.83 and ultrasound had a likelihood of 0-0.77 for detecting synovitis and tenosynovitis at one time. The two imaging modalities were equally competitive for detecting synovitis and tenosynovitis (p=0.055). CONCLUSION: Ultrasound could be as sensitive and specific as contrast-enhanced MRI for the diagnosis of subclinical synovitis and tenosynovitis.
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spelling pubmed-69631612020-02-07 Ultrasound Versus Contrast-Enhanced Magnetic Resonance Imaging for Subclinical Synovitis and Tenosynovitis: A Diagnostic Performance Study Bao, Zhongtao Zhao, Yanchun Chen, Shuqiang Chen, Xiaoyu Xu, Xiang Wei, Linglin Xiong, Meilian Clinics (Sao Paulo) Original Article OBJECTIVES: Radiographic manifestations of synovitis (e.g., erosions) can be observed only in the late stage of rheumatoid arthritis. Ultrasound is a noninvasive, cheap, and widely available technique that enables the evaluation of inflammatory changes in the peripheral joint. In the same way, dynamic contrast-enhanced magnetic resonance imaging (MRI) enables qualitative and quantitative measurements. The objectives of the study were to compare the sensitivity and accuracy of ultrasound in detecting subclinical synovitis and tenosynovitis with those of contrast-enhanced MRI. METHODS: The ultrasonography and contrast-enhanced MRI findings of the wrist, metacarpophalangeal, and proximal interphalangeal joints (n=450) of 75 patients with a history of joint pain and morning stiffness between 6 weeks and 2 years were reviewed. The benefits score was evaluated for each modality. RESULTS: The ultrasonic findings showed inflammation in 346 (77%) joints, while contrast-enhanced MRI found signs of early rheumatoid arthritis in 372 (83%) joints. The sensitivities of ultrasound and contrast-enhanced MRI were 0.795 and 0.855, respectively, and the accuracies were 0.769 and 0.823, respectively. Contrast-enhanced MRI had a likelihood of 0-0.83 and ultrasound had a likelihood of 0-0.77 for detecting synovitis and tenosynovitis at one time. The two imaging modalities were equally competitive for detecting synovitis and tenosynovitis (p=0.055). CONCLUSION: Ultrasound could be as sensitive and specific as contrast-enhanced MRI for the diagnosis of subclinical synovitis and tenosynovitis. Faculdade de Medicina / USP 2020-01-14 2020 /pmc/articles/PMC6963161/ /pubmed/31967284 http://dx.doi.org/10.6061/clinics/2020/e1500 Text en Copyright © 2020 CLINICS http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.
spellingShingle Original Article
Bao, Zhongtao
Zhao, Yanchun
Chen, Shuqiang
Chen, Xiaoyu
Xu, Xiang
Wei, Linglin
Xiong, Meilian
Ultrasound Versus Contrast-Enhanced Magnetic Resonance Imaging for Subclinical Synovitis and Tenosynovitis: A Diagnostic Performance Study
title Ultrasound Versus Contrast-Enhanced Magnetic Resonance Imaging for Subclinical Synovitis and Tenosynovitis: A Diagnostic Performance Study
title_full Ultrasound Versus Contrast-Enhanced Magnetic Resonance Imaging for Subclinical Synovitis and Tenosynovitis: A Diagnostic Performance Study
title_fullStr Ultrasound Versus Contrast-Enhanced Magnetic Resonance Imaging for Subclinical Synovitis and Tenosynovitis: A Diagnostic Performance Study
title_full_unstemmed Ultrasound Versus Contrast-Enhanced Magnetic Resonance Imaging for Subclinical Synovitis and Tenosynovitis: A Diagnostic Performance Study
title_short Ultrasound Versus Contrast-Enhanced Magnetic Resonance Imaging for Subclinical Synovitis and Tenosynovitis: A Diagnostic Performance Study
title_sort ultrasound versus contrast-enhanced magnetic resonance imaging for subclinical synovitis and tenosynovitis: a diagnostic performance study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6963161/
https://www.ncbi.nlm.nih.gov/pubmed/31967284
http://dx.doi.org/10.6061/clinics/2020/e1500
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