ationale and Objectives:To evaluate the role of musculoskeletal ultrasound(MSUS) in the grading ofrheumatoid arthritis (RA) wrist and hand joints and correlate it with clinical, laboratory,and radiological data.Material and MethodsA cross-sectional study recruited 50 patients in a tertiary care hospital. RA activity wasassessed by DAS28. MSUS dorsal longitudinal scan was performed on the wrists,MCPs, and PIPS joints using high frequency (18 MHZ) linear transducer. 100 wrists inthree different views, 500 MCPs, 500 PIPs were evaluated using the grey scaleultrasound (GSUS) and power Doppler ultrasound (PDUS) semiquantitative scale andscores ranging from 0-3. The results were correlated with clinical, laboratory andradiological data. All patients’ wrist and hand joints X-rays were evaluated using theLarsen score.ResultsThe mean age of the patients (49 females and one male) was 44.58 ± 10.07 years,and their mean disease duration was 16.26±1.07 years. The mean DAS28 was5.19±0.95. 97.5% of joints had grade I Larsen score, 11.07% of the joints haderosions, 9.2% of the joints had effusions, 23.8% of the joints had synovial thickening,11.9% of the joints showed PD signals and 3.5% of the joints were accompanied withtenosynovitis. Significant relations (p0.05) found among DAS28 and (PD signals,synovial thickening, tenosynovitis, effusion, and Larsen score). A non-significantrelation (p>0.05) among DAS28 and erosions detected by MSUS and X-ray. ConclusionMSUS is powerful in the detection of early RA regarding synovitis, joint effusion,tenosynovitis,and bone erosions, which were correlated with clinical and laboratoryparameters

ationale and Objectives:To evaluate the role of musculoskeletal ultrasound(MSUS) in the grading ofrheumatoid arthritis (RA) wrist and hand joints and correlate it with clinical, laboratory,and radiological data.Material and MethodsA cross-sectional study recruited 50 patients in a tertiary care hospital. RA activity wasassessed by DAS28. MSUS dorsal longitudinal scan was performed on the wrists,MCPs, and PIPS joints using high frequency (18 MHZ) linear transducer. 100 wrists inthree different views, 500 MCPs, 500 PIPs were evaluated using the grey scaleultrasound (GSUS) and power Doppler ultrasound (PDUS) semiquantitative scale andscores ranging from 0-3. The results were correlated with clinical, laboratory andradiological data. All patients’ wrist and hand joints X-rays were evaluated using theLarsen score.ResultsThe mean age of the patients (49 females and one male) was 44.58 ± 10.07 years,and their mean disease duration was 16.26±1.07 years. The mean DAS28 was5.19±0.95. 97.5% of joints had grade I Larsen score, 11.07% of the joints haderosions, 9.2% of the joints had effusions, 23.8% of the joints had synovial thickening,11.9% of the joints showed PD signals and 3.5% of the joints were accompanied withtenosynovitis. Significant relations (p0.05) found among DAS28 and (PD signals,synovial thickening, tenosynovitis, effusion, and Larsen score). A non-significantrelation (p>0.05) among DAS28 and erosions detected by MSUS and X-ray. ConclusionMSUS is powerful in the detection of early RA regarding synovitis, joint effusion,tenosynovitis,and bone erosions, which were correlated with clinical and laboratoryparameters

ationale and Objectives:To evaluate the role of musculoskeletal ultrasound(MSUS) in the grading ofrheumatoid arthritis (RA) wrist and hand joints and correlate it with clinical, laboratory,and radiological data.Material and MethodsA cross-sectional study recruited 50 patients in a tertiary care hospital. RA activity wasassessed by DAS28. MSUS dorsal longitudinal scan was performed on the wrists,MCPs, and PIPS joints using high frequency (18 MHZ) linear transducer. 100 wrists inthree different views, 500 MCPs, 500 PIPs were evaluated using the grey scaleultrasound (GSUS) and power Doppler ultrasound (PDUS) semiquantitative scale andscores ranging from 0-3. The results were correlated with clinical, laboratory andradiological data. All patients’ wrist and hand joints X-rays were evaluated using theLarsen score.ResultsThe mean age of the patients (49 females and one male) was 44.58 ± 10.07 years,and their mean disease duration was 16.26±1.07 years. The mean DAS28 was5.19±0.95. 97.5% of joints had grade I Larsen score, 11.07% of the joints haderosions, 9.2% of the joints had effusions, 23.8% of the joints had synovial thickening,11.9% of the joints showed PD signals and 3.5% of the joints were accompanied withtenosynovitis. Significant relations (p0.05) found among DAS28 and (PD signals,synovial thickening, tenosynovitis, effusion, and Larsen score). A non-significantrelation (p>0.05) among DAS28 and erosions detected by MSUS and X-ray. ConclusionMSUS is powerful in the detection of early RA regarding synovitis, joint effusion,tenosynovitis,and bone erosions, which were correlated with clinical and laboratoryparameters

ationale and Objectives:To evaluate the role of musculoskeletal ultrasound(MSUS) in the grading ofrheumatoid arthritis (RA) wrist and hand joints and correlate it with clinical, laboratory,and radiological data.Material and MethodsA cross-sectional study recruited 50 patients in a tertiary care hospital. RA activity wasassessed by DAS28. MSUS dorsal longitudinal scan was performed on the wrists,MCPs, and PIPS joints using high frequency (18 MHZ) linear transducer. 100 wrists inthree different views, 500 MCPs, 500 PIPs were evaluated using the grey scaleultrasound (GSUS) and power Doppler ultrasound (PDUS) semiquantitative scale andscores ranging from 0-3. The results were correlated with clinical, laboratory andradiological data. All patients’ wrist and hand joints X-rays were evaluated using theLarsen score.ResultsThe mean age of the patients (49 females and one male) was 44.58 ± 10.07 years,and their mean disease duration was 16.26±1.07 years. The mean DAS28 was5.19±0.95. 97.5% of joints had grade I Larsen score, 11.07% of the joints haderosions, 9.2% of the joints had effusions, 23.8% of the joints had synovial thickening,11.9% of the joints showed PD signals and 3.5% of the joints were accompanied withtenosynovitis. Significant relations (p0.05) found among DAS28 and (PD signals,synovial thickening, tenosynovitis, effusion, and Larsen score). A non-significantrelation (p>0.05) among DAS28 and erosions detected by MSUS and X-ray. ConclusionMSUS is powerful in the detection of early RA regarding synovitis, joint effusion,tenosynovitis,and bone erosions, which were correlated with clinical and laboratoryparameters

Background The carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy. Therefore, this study aimed to determine the diagnostic efficacy of the gray-scale and Doppler sonography in the diagnosis and grading of patients with CTS. Patients and methods This is a prospective study conducted on 40 adult patients (28 women and 12 men; 76 wrists). Twenty were suffering from CTS, and the other 20 were healthy controls. All of them were examined using a 7–12 MHz linear transducer. Presence of median nerve edema, swelling, flattening ratio of the median nerve, and bowing of the flexor retinaculum were evaluated by gray-scale sonography while Doppler sonography evaluated intraneural hypervascularity. Sensitivity and specificity were calculated considering the nerve conduction studies as a gold standard. Results Cross-sectional area (CSA) inlet has the highest sensitivity and accuracy in the diagnosis of CTS (92 and 90%, respectively) in addition to subjective ultrasonography findings such as nerve edema and nerve mobility which had a100% specificity. Doppler examination findings also had a high specificity of 92%. Combined CSA inlet and the swelling ratio have a higher diagnostic accuracy of 95% in diagnosing CTS compared with CSA inlet alone. The CSA inlet used in the grading of CTS with cutoff values of 9–15 mm2 for mild CTS, CSA more than 15 mm2 for moderate CTS, and CSA more than or equal to 16 mm2 for severe CTS. Conclusion A combination of CSA inlet and swelling ratio have the highest sensitivity and accuracy than CSA inlet alone in diagnosing CTS.

Background The carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy. Therefore, this study aimed to determine the diagnostic efficacy of the gray-scale and Doppler sonography in the diagnosis and grading of patients with CTS. Patients and methods This is a prospective study conducted on 40 adult patients (28 women and 12 men; 76 wrists). Twenty were suffering from CTS, and the other 20 were healthy controls. All of them were examined using a 7–12 MHz linear transducer. Presence of median nerve edema, swelling, flattening ratio of the median nerve, and bowing of the flexor retinaculum were evaluated by gray-scale sonography while Doppler sonography evaluated intraneural hypervascularity. Sensitivity and specificity were calculated considering the nerve conduction studies as a gold standard. Results Cross-sectional area (CSA) inlet has the highest sensitivity and accuracy in the diagnosis of CTS (92 and 90%, respectively) in addition to subjective ultrasonography findings such as nerve edema and nerve mobility which had a100% specificity. Doppler examination findings also had a high specificity of 92%. Combined CSA inlet and the swelling ratio have a higher diagnostic accuracy of 95% in diagnosing CTS compared with CSA inlet alone. The CSA inlet used in the grading of CTS with cutoff values of 9–15 mm2 for mild CTS, CSA more than 15 mm2 for moderate CTS, and CSA more than or equal to 16 mm2 for severe CTS. Conclusion A combination of CSA inlet and swelling ratio have the highest sensitivity and accuracy than CSA inlet alone in diagnosing CTS.

Background The carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy. Therefore, this study aimed to determine the diagnostic efficacy of the gray-scale and Doppler sonography in the diagnosis and grading of patients with CTS. Patients and methods This is a prospective study conducted on 40 adult patients (28 women and 12 men; 76 wrists). Twenty were suffering from CTS, and the other 20 were healthy controls. All of them were examined using a 7–12 MHz linear transducer. Presence of median nerve edema, swelling, flattening ratio of the median nerve, and bowing of the flexor retinaculum were evaluated by gray-scale sonography while Doppler sonography evaluated intraneural hypervascularity. Sensitivity and specificity were calculated considering the nerve conduction studies as a gold standard. Results Cross-sectional area (CSA) inlet has the highest sensitivity and accuracy in the diagnosis of CTS (92 and 90%, respectively) in addition to subjective ultrasonography findings such as nerve edema and nerve mobility which had a100% specificity. Doppler examination findings also had a high specificity of 92%. Combined CSA inlet and the swelling ratio have a higher diagnostic accuracy of 95% in diagnosing CTS compared with CSA inlet alone. The CSA inlet used in the grading of CTS with cutoff values of 9–15 mm2 for mild CTS, CSA more than 15 mm2 for moderate CTS, and CSA more than or equal to 16 mm2 for severe CTS. Conclusion A combination of CSA inlet and swelling ratio have the highest sensitivity and accuracy than CSA inlet alone in diagnosing CTS.

Background:Knee osteoarthritis (KOA) is the most common cause of a painful joint, and it is associated withsignificant health economic consequences. About literature, KOA is usually diagnosed according to changes seenon conventional radiography, but the radiographic features of OA do not correlate with its symptoms. Nowadays,ultrasonography is becoming a non-invasive imaging tool for OA in the clinical setting. Thus, the purpose of thisstudy was to evaluate the correlation between musculoskeletal ultrasound (MSK US) and the Western Ontario andMcMaster University (WOMAC) osteoarthritis index findings in patients with primary knee osteoarthritis (KOA).Methods:Between August 2015 and October 2017, 50 patients with a mean age of 46.72 ± 9.12 years who fulfilled theAmerican College of Rheumatology (ACR) criteria for KOA were included. All the patients underwent a clinicalassessment with the calculation of the WOMAC index, and they underwent knee US examination and conventionalradiography (CR). Spearman’s rho was used to assess the association between MSK US findings and the WOMAC index.Results:The mean pain score was 10.08 ± 2.89, stiffness was 3.34 ± 1.72, physical function was 26.26 ± 9.6, and the totalWOMAC score was 39.68 ± 12.83. Forty-seven knees showed radiographic femorotibial degenerative signs. The meanthicknesses of the ultrasound-measured articular cartilage of the medial condyle (MC), intercondylar notch area (IA),and lateral condyle (LC) were 0.23 ± 0.60 cm, 0.33 ± 0.69 cm, and 0.30 ± 0.81 cm, respectively. The US findings alsoincluded suprapatellar joint effusion (50%), medial meniscal extrusion (40%), and osteophytes (70%). A positivecorrelation was found between the mean articular cartilage thickness of the IA, mean pain score, and stiffnesssubclasses of the WOMAC score (r=0.342,p=0.015;r=0.414,p=0.003),respectively.Conclusions:The severity of KOA, based on articular cartilage thickness, showed good correlation with the pain andstiffness subclasses of the WOMAC score.

Background:Knee osteoarthritis (KOA) is the most common cause of a painful joint, and it is associated withsignificant health economic consequences. About literature, KOA is usually diagnosed according to changes seenon conventional radiography, but the radiographic features of OA do not correlate with its symptoms. Nowadays,ultrasonography is becoming a non-invasive imaging tool for OA in the clinical setting. Thus, the purpose of thisstudy was to evaluate the correlation between musculoskeletal ultrasound (MSK US) and the Western Ontario andMcMaster University (WOMAC) osteoarthritis index findings in patients with primary knee osteoarthritis (KOA).Methods:Between August 2015 and October 2017, 50 patients with a mean age of 46.72 ± 9.12 years who fulfilled theAmerican College of Rheumatology (ACR) criteria for KOA were included. All the patients underwent a clinicalassessment with the calculation of the WOMAC index, and they underwent knee US examination and conventionalradiography (CR). Spearman’s rho was used to assess the association between MSK US findings and the WOMAC index.Results:The mean pain score was 10.08 ± 2.89, stiffness was 3.34 ± 1.72, physical function was 26.26 ± 9.6, and the totalWOMAC score was 39.68 ± 12.83. Forty-seven knees showed radiographic femorotibial degenerative signs. The meanthicknesses of the ultrasound-measured articular cartilage of the medial condyle (MC), intercondylar notch area (IA),and lateral condyle (LC) were 0.23 ± 0.60 cm, 0.33 ± 0.69 cm, and 0.30 ± 0.81 cm, respectively. The US findings alsoincluded suprapatellar joint effusion (50%), medial meniscal extrusion (40%), and osteophytes (70%). A positivecorrelation was found between the mean articular cartilage thickness of the IA, mean pain score, and stiffnesssubclasses of the WOMAC score (r=0.342,p=0.015;r=0.414,p=0.003),respectively.Conclusions:The severity of KOA, based on articular cartilage thickness, showed good correlation with the pain andstiffness subclasses of the WOMAC score.

Background:Knee osteoarthritis (KOA) is the most common cause of a painful joint, and it is associated withsignificant health economic consequences. About literature, KOA is usually diagnosed according to changes seenon conventional radiography, but the radiographic features of OA do not correlate with its symptoms. Nowadays,ultrasonography is becoming a non-invasive imaging tool for OA in the clinical setting. Thus, the purpose of thisstudy was to evaluate the correlation between musculoskeletal ultrasound (MSK US) and the Western Ontario andMcMaster University (WOMAC) osteoarthritis index findings in patients with primary knee osteoarthritis (KOA).Methods:Between August 2015 and October 2017, 50 patients with a mean age of 46.72 ± 9.12 years who fulfilled theAmerican College of Rheumatology (ACR) criteria for KOA were included. All the patients underwent a clinicalassessment with the calculation of the WOMAC index, and they underwent knee US examination and conventionalradiography (CR). Spearman’s rho was used to assess the association between MSK US findings and the WOMAC index.Results:The mean pain score was 10.08 ± 2.89, stiffness was 3.34 ± 1.72, physical function was 26.26 ± 9.6, and the totalWOMAC score was 39.68 ± 12.83. Forty-seven knees showed radiographic femorotibial degenerative signs. The meanthicknesses of the ultrasound-measured articular cartilage of the medial condyle (MC), intercondylar notch area (IA),and lateral condyle (LC) were 0.23 ± 0.60 cm, 0.33 ± 0.69 cm, and 0.30 ± 0.81 cm, respectively. The US findings alsoincluded suprapatellar joint effusion (50%), medial meniscal extrusion (40%), and osteophytes (70%). A positivecorrelation was found between the mean articular cartilage thickness of the IA, mean pain score, and stiffnesssubclasses of the WOMAC score (r=0.342,p=0.015;r=0.414,p=0.003),respectively.Conclusions:The severity of KOA, based on articular cartilage thickness, showed good correlation with the pain andstiffness subclasses of the WOMAC score.