Spectral doppler and resistive index: A promising tool in ultrasonographic evaluation of inflammation in rheumatoid arthritis

To evaluate the use of spectral Doppler in the longitudinal follow-up of inflammatory joint involvement in rheumatoid arthritis (RA) by comparing resistive index (RI) findings with color fraction and pain on a visual analog scale (VAS). Five patients on unchanged disease modifying anti-rheumatic dru...

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Bibliographic Details
Published in:Acta radiologica (1987) 2003-11, Vol.44 (6), p.645-652
Main Authors: TERSLEV, L, TORP-PEDERSEN, S, QVISTGAARD, E, BLIDDAL, H
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Arthritis, Rheumatoid - diagnostic imaging
Arthritis, Rheumatoid - drug therapy
Arthritis, Rheumatoid - pathology
Biological and medical sciences
Female
Glucocorticoids - administration & dosage
Humans
Inflammation
Injections, Intra-Articular
Investigative techniques, diagnostic techniques (general aspects)
Joints
Male
Medical sciences
Middle Aged
Ultrasonic investigative techniques
Ultrasonography, Doppler - methods
Vas Deferens
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Summary:To evaluate the use of spectral Doppler in the longitudinal follow-up of inflammatory joint involvement in rheumatoid arthritis (RA) by comparing resistive index (RI) findings with color fraction and pain on a visual analog scale (VAS). Five patients on unchanged disease modifying anti-rheumatic drugs (DMARD) treatment were followed after an intra-articular corticosteroids injection and received no further injections in the observation period. They were followed clinically and by ultrasound using color Doppler pixels and the spectral Doppler RI as indicators of inflammation. At 1, 6 and 12 months the measurements were repeated on the same joint. At 1-month follow-up after the corticosteroids injection, a marked decrease in the color fraction was seen in 4 out of 5 patients, while the fifth patient had a moderate decrease (Wilcoxon p < 0.05). The changes in RI showed correspondingly a marked increase in 4 out of 5 patients indicating a diminished flow to the synovium (Wilcoxon p < 0.05). The effect of the corticosteroid injection could still be seen after 1 year in 4 out of 5 patients. In RI, pixel fraction and VAS there was improvement compared with the baseline values; however, only the pixel fraction was statistically significant (Wilcoxon p < 0.05). RI seems to be an objective alternative to pixel estimation of the degree of inflammation and treatment response in RA.
ISSN:0284-1851
1600-0455
DOI:10.1046/j.1600-0455.2003.00136.x