Proposal for a sonographic classification of target joints in rheumatoid arthritis.
OBJECTIVE
The purpose of this study was to classify sonographically the joint damage of target joints in patients with rheumatoid arthritis (RA).


METHODS
During a 3-year cross-sectional study, standardized arthrosonography of symptomatic target joints was performed in patients with RA. According to those findings, a classification with progressive deterioration of joint alteration in RA was created that grades visible morphological changes of the joint components. Using elbow joints as a subgroup, inter- and intraobserver reliability was calculated.


RESULTS
Examined and included in this study were 1211 joints of 425 patients with RA. The mean disease activity score was 5.2 (range 0.75-7.79). Sonographically visible changes could be classified and divided into six stages. A standardized sonographic evaluation system was developed. In reference to the elbow joint, overall percentages for intra- and interobserver reliability of sonography were 90.8% and 88.8%, respectively.


CONCLUSIONS
Sonography is a valuable tool for assessing and classifying joint alteration in RA. Particularly in early stages of joint affection, ultrasound is superior to X-ray in detecting soft tissue changes and minor erosions.
Lerch
Klaus
K
Department of Orthopedic Surgery, University of Regensburg, Kaiser-Karl-V. Allee 3, Bad Abbach, Germany. klaus.lerch@klinik.uni-regensburg.de
Borisch
Nicola
N
Paetzel
Christian
C
Grifka
Joachim
J
Hartung
Wolfgang
W
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000145:classification* / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D018450:Disease Progression; D042241:Early Diagnosis; D004551:Elbow Joint / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012737:Sex Factors; D018608:Ultrasonography, Doppler / Q000379:methods*