Arthritis of the finger joints: A comprehensive approach comparing conventional radiography, scintigraphy, ultrasound, and contrast-enhanced magnetic resonance imaging
Article first published online: 26 APR 2001
Copyright © 1999 by the American College of Rheumatology
Arthritis & Rheumatism
Volume 42, Issue 6, pages 1232–1245, June 1999
How to Cite
Backhaus, M., Kamradt, T., Sandrock, D., Loreck, D., Fritz, J., Wolf, K. J., Raber, H., Hamm, B., Burmester, G.-R. and Bollow, M. (1999), Arthritis of the finger joints: A comprehensive approach comparing conventional radiography, scintigraphy, ultrasound, and contrast-enhanced magnetic resonance imaging. Arthritis & Rheumatism, 42: 1232–1245. doi: 10.1002/1529-0131(199906)42:6<1232::AID-ANR21>3.0.CO;2-3
- Issue published online: 26 APR 2001
- Article first published online: 26 APR 2001
- Manuscript Accepted: 29 DEC 1998
- Manuscript Received: 6 JUL 1998
- Charité Medical School
- Humboldt University of Berlin
- Senatsverwaltung für Wissenschaft und Kultur
A prospective study was performed comparing conventional radiography, 3-phase bone scintigraphy, ultrasound, and magnetic resonance imaging (MRI) with precontrast and dynamic postcontrast examinations in 60 patients with various forms of arthritis including rheumatoid arthritis (RA), spondylarthropathy, and arthritis associated with connective tissue disease.
A total of 840 finger joints were examined clinically and by all 4 imaging methods. Experienced investigators blinded to the clinical findings and diagnoses analyzed all methods independently of each other. The patients were divided into 2 groups. Group 1 included 32 patients (448 finger joints) without radiologic signs of destructive arthritis (Larsen grades 0–1) of the evaluated hand and wrist and group 2 included 28 patients (392 finger joints) with radiographs revealing erosions (Larsen grade 2) of the evaluated hand and/or wrist.
Clinical evaluation, scintigraphy, MRI, and ultrasound were each more sensitive than conventional radiography in detecting inflammatory soft tissue lesions as well as destructive joint processes in arthritis patients in group 1. All differences were statistically significant. We found ultrasound to be even more sensitive than MRI in the detection of synovitis. MRI detected erosions in 92 finger joints (20%; 26 patients) in group 1 that had not been detected by conventional radiography.
Our data indicate that MRI and ultrasound are valuable diagnostic methods in patients with arthritis who have normal findings on radiologic evaluation.