Abstract
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.
Key words
ultrasound - arthritides - hand
