To evaluate the sensitivity and predictive value of grey scale and power Doppler ultrasound assessment of bone erosionin disease activity in patients with early rheumatoid arthritis (RA).
Fifty-six patients with early RA underwent blinded sequential clinical, laboratory and ultrasound assessments, and at the same time 20 of these patients underwent X-ray and enhanced MRI. For each patient, 28-joint disease activity score (DAS28), erythrocyte sedimentation rate (ESR), C reactive protein (CRP) and health assessment questionnaire (HAQ) were recorded. The presence of bone erosion and synovitis was investigated in 28 joints by gray-scale and power Doppler ultrasonography. The ultrasound joint count and index for active synovitis with power Doppler signal were calculated.
The number of bone erosions detected by ultrasonography was 5.7 times that of X-ray, while both MRI and ultrasonography were consistent (91.5%). The number of synovitis detected by ultrasonography was 1.6 times as much as by physical examination, and consistent MRI (95.7%). PDUS parameters demonstrated a highly significant correlation with DAS28, ESR and CRP, while a negative correlation with HAQ.
Grey scale and power Doppler ultrasonography is a sensitive and reliable method to assess bone erosion and inflammatory activity in early RA. PDUS findings may have a predictive value in disease activity.