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Ultrasound Detects Joint Involvement In Rheumatoid Arthritics

Ultrasound imaging is an important diagnostic tool for evaluating temporomandibular joint (TMJ) involvement in rheumatoid arthritis and psoriatic arthritis.

Researchers in Italy make this suggestion following a study aimed at defining the diagnostic value of ultrasound (US) examination compared with magnetic resonance imaging (MRI) in the clinical assessment of TMJ in patients with these disorders.

This study of 33 patients was led by Dr D Melchiorre from the University of Florence, with contributors from the University of Pisa, and the Campo di Marte Hospital, Lucca.

Of the 33 participating patients, 22 had rheumatoid arthritis (RA) and 11 had psoriatic arthritis (PsA). All underwent both MRI and US examinations.

The investigators evaluated alterations of the disc, alterations of the condyle and joint effusion and calculated the sensitivity and specificity of US in comparison with MRI.

Pathological changes of the TMJ were observed by MRI in 24 patients and by US in 31 patients. The sensitivity of US was 72.2% and the specificity was 60% in the assessment of pathological changes of the TMJ.

In the assessment of alterations of the disc, US sensitivity was 69.6% with specificity of 30%, and in assessment of joint effusion, the sensitivity was 70.6% with specificity of 75%.

The investigators observed no significant concordance between the two diagnostic approaches in the assessment of condylar alterations.
Rheumatology (Oxford) 2003 May;42:5:673-676. "A comparison of ultrasonography and magnetic resonance imaging in the evaluation of temporomandibular joint involvement in rheumatoid arthritis and psoriatic arthritis"

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