Assessment of proximal finger joint inflammation in patients with rheumatoid arthritis, using a novel laser‐based imaging technique

Abstract

Objective. To evaluate a newly developed laserbased imaging technique for the study of soft tissue changes and acute inflammatory processes of the proximal interphalangeal (PIP) joints in patients with rheumatoid arthritis (RA).Methods. A novel imaging device was developed which allows the transillumination of PIP joints using laser light in the near-infrared wavelength range. In a first clinical followup study, a total of 72 PIP joints of 22 patients with RA and 64 PIP joints of 8 healthy controls were examined both clinically and with the new laser device. At baseline and at followup after a mean of 6 weeks, clinical signs of synovitis, the joint circumference, and the degree of pain were assessed for each PIP joint in order to determine the clinical degree of inflammation. Different features were extracted from the laser images and evaluated by a neural network.Results. At baseline, 72 PIP joints in the RA patients showed clinical signs of inflammation. At followup, 45 PIP joints showed clinical improvement, 13 showed steady active inflammation, and 14 showed deterioration compared with the first visit. None of the 64 PIP joints in the healthy individuals showed any signs of synovitis. The inflammatory status of 60 of the 72 RA joints examined was classified correctly by laser examination and joint circumference determination, giving a sensitivity of 80%, a specificity of 89%, and an accuracy of 83% in detecting inflammatory changes in affected joints. Laser data and joint circumference determination of healthy joints at followup resulted in an accuracy of 85% in reproducing the image.Conclusion. The new laser-based imaging technique allows the transillumination of PIP joints and gives information about the inflammatory status of the joint after processing through a neural network. Our data indicate that laser imaging may provide additional information in the early diagnosis of an inflammatory joint process and may prove particularly useful in assessing acute joint inflammation at followup.

The analysis of laser light scattering during rheumatoid arthritis by image segmentation

“…Scheel et al [9] demonstrated that laser transillumination of finger joints can be useful as a sensitive follow-up analysis of joint inflammation. A neural network was employed for the classification of the one-dimensional scattering distributions, see Fig.…”

“…The small geometry of the joints supports the application of this non-invasive method of examination [4,7,8]. A first clinical study [9] showed that laser transillumination of finger joints could be useful as a sensitive follow-up analysis of joint inflammation when complemented with an adequate image processing. For that purpose a new image segmentation algorithm [10] based on a non-local phase separation model is proposed.…”

RA diagnostics using laser-optical images and conventional X-rays (fused imaging)

“…This is why a so-called ''functional imaging procedure'' using for example MRT, is recommended as a complementary procedure to radiography. The comparatively low-cost optical diagnostics procedure would offer an interesting alternative, particularly as it has already proven successful in the first two studies [14,15].…”

Pseudo colour visualization of fused multispectral laser scattering images for optical diagnosis of rheumatoid arthritis

“…Besides expensive tomographic approaches a robust procedure has become established in optical diagnostics of rheumatism: the PIP joint to be examined is transilluminated using a (laser diode or LED) point source and the scattered light image is plotted by a CCD camera [6][7][8]. Monte-Carlo simulations confirm the experimental outcome [9].…”