RESEARCH - Measuring finger joint cartilage by ultrasound as a promising alternative to conventional radiograph imaging

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Arthritis Rheum. 2009 Apr 15;61(4):435-41.

Measuring finger joint cartilage by ultrasound as a promising

alternative to conventional radiograph imaging.

Möller B, Bonel H, Rotzetter M, Villiger PM, Ziswiler HR.

University Hospital Berne, Inselspital, Berne, Switzerland.

OBJECTIVE: To evaluate the reliability and validity of a novel

ultrasound (US) imaging method to measure metacarpophalangeal (MCP)

and proximal interphalangeal (PIP) finger joint cartilage.

METHODS: We examined 48 patients with rheumatoid arthritis (RA), 18

patients with osteoarthritis (OA), 24 patients with unclassified

arthritis of the finger joints, and 34 healthy volunteers. The

proximal cartilage layer of MCP and PIP joints for fingers 2-5 was

bilaterally visualized from a posterior view, with joints in

approximately 90 degrees flexion. Cartilage thickness was measured

with integrated tools on static images. External validity was assessed

by measuring radiologic joint space width (JSW) and a numeric joint

space narrowing (JSN) score in patients with RA.

RESULTS: Precise measurement was possible for 97.5% of MCP and 94.2%

of PIP joints. Intraclass correlation coefficients for bilateral total

joint US scores were 0.844 (95% confidence interval [95% CI]

0.648-0.935) for interobserver comparisons and 0.928 (95% CI

0.826-0.971) for intraobserver comparisons (using different US

devices). The US score correlated with JSN for both hands (adjusted

R(2) = 0.513, P < 0.001) and JSW of the same finger joints (adjusted

R(2) = 0.635, P < 0.001). Reduced cartilage shown by US allowed

discrimination of early symptomatic OA versus early RA and healthy

joints. In patients with RA, US scores correlated with duration of

treatment-resistant, progressive RA.

CONCLUSION: The US method of direct visualization and quantification

of cartilage in MCP and PIP joints is objective, reliable, valid, and

can be useful for diagnostic purposes in patients with arthritis.

PMID: 19333990

http://www.ncbi.nlm.nih.gov/pubmed/19333990

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