Musculoskeletal ultrasound versus MRI of the hands in healthy subjects – a pilot study

Abstract

Aim: High resolution imaging methods detect a spectrum of inflammatory-like and structural modifications at joint and tendon level in healthy subjects. The knowledge of their extent and degree is important when subclinical disease activity (implying therapy reassessment) must be differentiated from normality. Musculoskeletal ultrasound (MSUS) evaluation may be challenging even for experts when borderline or low grade lesions are present. Our objective was to analyse the frequency of inflammatory-like lesions in hand joint and tendons in healthy young subjects and to evaluate the concordance between MSUS and magnetic resonance imaging (MRI) findings. Material and methods: Ten healthy young women (age range 24-32 years) clinically asymptomatic (joints and tendons) were selected to have bilateral hand MSUS and MRI evaluation. Based on current definitions, synovitis/tenosynovitis-like lesions, erosions, osteophytes and bone edema were quantified and concordance between the two imaging methods was calculated. Results: Overall, both imaging evaluation methods showed a low frequency of inflammatory-like and structural lesions. No joint presented power Doppler signal or erosions. No abnormalities suggestive for inflammatory or structural pathology were detected at the tendon compartments level. No erosions and no signs of osteitis were detected. The concordance between MSUS and MRI findings was high except for the wrist area. Conclusion: MSUS was demonstrated to be a very accurate imaging method, mostly for hand tendon evaluation. This would allow a better discrimination between normality and pathologic findings, adding supplementary information.

Ultrasound-Guided Procedures in Rheumatology Daily Practice

“…Finally, our data support the safety of US-guided procedures. In fact, these results are consistent with previous studies 28,31,32,38,39 showing a low incidence of adverse reaction after musculoskeletal interventional procedures. Of the 643 US-guided procedures performed over 6 months, there were only 5 major adverse events (0.8%): 4 were likely related to the procedure (local skin depigmentation after steroid injection, pseudoseptic synovitis after viscosupplementation, and postprocedure vasovagal reaction) and 1 was possibly related to the procedure (aseptic hip osteonecrosis in an obese patient with psoriatic arthritis and severe hip osteoarthritis requiring joint replacement).…”

“…In fact, the mean time of the whole procedure (excluding the acquisition of the informed consent) was 7 ± 2.5 minutes. These data are in line with the results of Micu et al 31 Assuming that an average duration of a follow-up rheumatology visit is 20 minutes in several countries such as Italy and United States, 37 we consider that spending one third of the time to perform a highly accurate, safe, and relatively painless procedure is acceptable in a service performing US-guided procedures.…”

“…The identification of the most suitable route for the needle, adopting an “in-plane” approach (the probe and the needle were maintained in the same spatial plane), defined as the shortest (the smallest distance between the skin and the target) and the safest (the one avoiding noble structures), and maintaining a security distance of approximately 5 mm between the footprint and the injection area 31 ;…”

The value of contrast-enhanced musculoskeletal ultrasound for early diagnosis, monitoring of disease activity and assessment of treatment efficacy in patients with rheumatoid arthritis and psoriatic arthritis

“…In 2019, Mihaela C. Micu et al conducted the fi rst study which compared the correspondence of MUS to MRI in the assessment of infl ammatory and structural changes in the joints and tendons of the hand in healthy volunteers. These authors concluded that MUS is a reliable method for evaluation of the joints and tendons of the hand, with the reported correspondence between the fi ndings in the tendons being 100% [12].…”

“…през 2019 г. правят първото проучване, в което сравняват съответствието между мускулно-скелетната ехография и МР при оценка на възпалителни и структурни промени на ставите и сухожилията на ръка при здрави доброволци. Те установяват, че ултрасонографията е надежден метод за оценка на ставите и сухожилията на ръката, като съответствието за находките при сухожилията е 100% [12]. them -no signal inversion or so-called aliasing, a weaker dependence on the angle of insonation and higher sensitivity for low-velocity blood fl ow.…”