الفهرس 
Introduction&Aim of the workOnly 14 pages are availabe for public view
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Abstract
Background: Angiogenesis is necessary for the continual proliferation of synovial tissue, it is believed to play an important role in the development and progression of rheumatoid arthritis (RA). Vascular endothelial growth factor (VEGF), the most potent angiogenic cytokine known that selectively acts on vascular endothelial cells causing their proliferation and migration to form new blood vessels. VEGF plays an important role in the pathogenesis of RA. It has been identified in the synovial membrane on inflamed joints in patients with RA. Power Doppler sonography (PDS) has been shown to depict the soft tissue vascular volume in joint inflammation and may be helpful in evaluating activity and efficacy of the therapeutic regimens. Subjects & methods: 50 rheumatoid knees from 50 patients were studied. All patients were subjected to the following : 1-Full history taking, general and systemic examination of locomotor system and examination of knee joints. 2-Laboratory investigations including: Full blood picture and HB concentrations, ESR, CRP, rheumatoid factor, measurement of VEGF in the serum and synovial fluid from knee joints. 3- Radiological investigations including: Plain radiography antero-posterior, lateral and sky line views of the knees, Ultrasonography of the knees, and Doppler sonography of the knees. Clinical, laboratory, and radiological data were collected from the patients at the study entry and six months after treatment. Results: VEGF concentrations are elevated in both serum & synovial fluids of patients with RA. Significant correlations were found between VEGF in serum & synovial fluids and clinical data of patients as morning stiffness, number of tender and swollen joints, disease activity and severity, and clinical index of knee inflammation. Also, significant correlations were found between VEGF and laboratory data as ESR and CRP, and also between sonographic findings as synovial thickness (pannus), effusion, grading of cartilage affection, and bone erosions. Furthermore, significant correlations were found between PDS and VEGF levels and various clinical, laboratory and sonographic findings including pannus, effusion, cartilage affection and bone erosions. Conclusions: VEGF measurement & Doppler sonography are sensitive methods correlating with vascular pannus, with its potential to cause cartilage and bone destruction. Early identification and suppression of pannus limits the progression of the disease and improves long term prognosis.