الفهرس 
Anatomy of the Wrist and Hand JointsOnly 14 pages are availabe for public view
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Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by the development of synovitis, which damages cartilage, bone, ligaments, and tendons. It preferentially affects the small joints of the hands and feet leading to synovial inflammation and various degrees of destruction of periarticular tissues. Synovial inflammation is accompanied by hyperemia, and during disease progression, angiogenesis in a hypervascularized of synovial hypertrophy appears to be a prerequisite for erosion to cartilage and bone. The evaluation of perfusion of synovial hypertrophy proved to be an important objective in evaluating synovial activity. Accurate assessment of disease activity and joint damage in rheumatoid arthritis is important for monitoring treatment efficiency and for prognoses of the disease. This requires sensitive imaging methods for detection and monitoring of the disease process.
High resolution ultrasound (HRUS) has become an established imaging technique for the diagnosis and follow-up of patients with rheumatoid arthritis. HRUS is most commonly used in the assessment of soft tissue disease or detection of fluid collection and can also be used to visualize other structures, such as cartilage and bone surfaces. HRUS complements the physical examination by allowing for visualization of synovitis and erosive changes. assessment of the degree of inflammation can be obtained with the use of color or power Doppler US.
This study was done to evaluate the role of gray scale ultrasound and power Doppler in the assessment of synovial thickening in the wrist joint and hand joints of early symptomatic RA patients.
Thirty patients, 25 females and 5 males suffering from rheumatoid arthritis were the subjects of this study, with age range from 20 to 50 years with a mean of 36.28 years±10.22 SD, with disease duration ranging from 2 months to one year with a mean of 6.9 months±4.67 SD.
All patients included in this study were subjected to full history taking, clinical examination by the referring rheumatologist, laboratory investigations as well as plain radiography, ultrasonography and Power Doppler assessment.
Results showed the following:
Synovial thickening was detected in 25 patients (83 %).
Active synovitis was detected by using Doppler US in 12 patients (40%).
Effusion was detected in 15 patients (50 %).
Bone erosions were detected in 6 patients (20 %).
X-ray finding was detected in 4 patients (13 %).
from our study we concluded that:
High-resolution ultrasonography (HRUS) is a reliable technique for:
a. Assessment of both soft tissue and destructive joint changes occur in early stage in rheumatoid arthritis.
b. Detection of synovial hypertrophy and effusion.
c. Depiction of bone erosions.
PDUS is an efficient technique to evaluate synoviatis vascularity and differentiating between inactive and active synovial hypertrophy.
US has the potential role to become an essential tool for diagnosis, baseline assessment and follow up of the patient with RA therapy.