Role of contrast-enhanced ultrasound in early diagnosis of psoriatic arthritis.
BACKGROUND
Radiographic examination (Rx) is still the best method to obtain an accurate diagnosis of psoriatic arthritis (PsA). Nevertheless, ultrasound (US) examination of the potentially involved joints has started to play a leading role. The sensitivity and specificity of a scan can be determined by contrast enhancement in the diagnosis of arthritis during PsA in comparison with basal US with MRI.


METHODS
Our study was made on 22 uninformed patients showing clinical suspicion of PsA. The patients were submitted to clinical evaluation, Rx, US with and without contrast enhancement and MRI. The parameters evaluated by basal US were effusion, synovial hypertrophy, positiveness to color power Doppler signals and bone erosion.


RESULTS
Contrast-enhanced US (CEUS) seems to amplify small alterations previously detected by US and, moreover, increases the diagnostic confidence in cases of suspected symptomatology with a negative diagnosis. Finally, CEUS appears to have a concordance of almost 100% with the results of MRI with contrast enhancement.


CONCLUSIONS
US appears to be an effective method for detecting the alterations in bone outline and soft tissues, such as synovitis. Furthermore, US provides useful information concerning the evolution of vascularization and the dynamic behavior of tendons.
Solivetti
F M
FM
Struttura di Radiologia e Diagnostica per Immagini, Istituto Dermosifilopatico di Santa Maria e San Gallicano, Roma, Italy. solivetti @ ifo.it
Elia
F
F
Teoli
M
M
De Mutiis
C
C
Chimenti
S
S
Berardesca
E
E
Di Carlo
A
A
D000328:Adult; D000368:Aged; D015535:Arthritis, Psoriatic / Q000000981:diagnostic imaging* / Q000473:pathology; D003287:Contrast Media; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007558:Italy; D007596:Joints / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012680:Sensitivity and Specificity; D013585:Synovitis / Q000175:diagnosis; D018615:Ultrasonography, Doppler, Color / Q000379:methods*
D003287:Contrast Media