title: Change of synovial vascularity in a single finger joint assessed by power doppler sonography correlated with radiographic change in rheumatoid arthritis: comparative study of a novel quantitative score with a semiquantitative score.
abstract: OBJECTIVE
  To investigate the relationship between synovial vascularity assessed by quantitative power Doppler sonography (PDS) and progression of structural bone damage in a single finger joint in patients with rheumatoid arthritis (RA).
  
  
  METHODS
  We studied 190 metacarpophalangeal (MCP) joints and 190 proximal interphalangeal (PIP) joints of 19 patients with active RA who had initial treatment with disease-modifying antirheumatic drugs (DMARDs). Patients were examined by clinical and laboratory assessments throughout the study. Hand and foot radiography was performed at baseline and the twentieth week. Magnetic resonance imaging (MRI) was performed at baseline. PDS was performed at baseline and the eighth week. Synovial vascularity was evaluated according to both quantitative and semiquantitative methods.
  
  
  RESULTS
  Quantitative PDS was significantly correlated with the enhancement rate of MRI in each single finger joint. Comparing quantitative synovial vascularity and radiographic change in single MCP or PIP joints, the level of vascularity at baseline showed a significant positive correlation with radiographic progression at the twentieth week. The change of vascularity in response to DMARDs, defined as the percentage change in vascularity by the eighth week from baseline, was inversely correlated with radiographic progression in each MCP joint. The quantitative PDS method was more useful than the semiquantitative method for the evaluation of synovial vascularity in a single finger joint.
  
  
  CONCLUSIONS
  The change of synovial vascularity in a single finger joint determined by quantitative PDS could numerically predict its radiographic progression. Using vascularity as a guide to consider a therapeutic approach would have benefits for patients with active RA.
authors.affiliation: Tokeidai Memorial Hospital, Sapporo, Japan. jun.fukae@ryumachi-jp.com
authors.forename: Jun
authors.initials: J
authors.lastname: Fukae
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Kon
authors.forename: Mihoko
authors.initials: M
authors.lastname: Henmi
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Sakamoto
authors.forename: Akihiro
authors.initials: A
authors.lastname: Narita
authors.forename: Masato
authors.initials: M
authors.lastname: Shimizu
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Tanimura
authors.forename: Megumi
authors.initials: M
authors.lastname: Matsuhashi
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Kamishima
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Atsumi
authors.forename: Takao
authors.initials: T
authors.lastname: Koike
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D001175:Arthrography; D018450:Disease Progression; D005260:Female; D005384:Finger Joint / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D013583:Synovial Membrane / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D018608:Ultrasonography, Doppler; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents