title: High-resolution ultrasound evaluation of extrinsic wrist ligaments in patients affected by rheumatoid arthritis.
abstract: OBJECTIVE
  To evaluate the ultrasound features of the extrinsic wrist ligaments in rheumatoid arthritis (RA) patients in comparison with healthy volunteers.
  
  
  METHODS
  Twenty-one consecutive patients affected by RA (12 men, 9 women; mean age 57 ± 14.6 years) were compared with 21 controls (12, 9; 54 ± 12.1, respectively). Wrists were evaluated using ultrasound on both palmar and dorsal sides along each ligament, using carpal bones as references. The following ligaments were studied: radioscaphocapitate, radiolunotriquetral, palmar ulnolunate, palmar ulnotriquetral, dorsal radiotriquetral, dorsal ulnotriquetral, and radial collateral ligament. Ligament number and thickness were noted. Echotexture was rated as fibrillar, fragmented, or heterogeneous; the surface was rated as smooth or blurred.
  
  
  RESULTS
  The number of palmar ulnolunate and palmar ulnotriquetral ligaments detected by ultrasound in patients was significantly lower than in controls (P = 0.031 and P = 0.037, respectively). All ligaments had significantly more fragmented or heterogeneous echotexture and blurred surface and were significantly thinner in patients than in controls (P < 0.001). No correlation was found between ligament thickness and RA duration or clinical parameters.
  
  
  CONCLUSIONS
  Extrinsic wrist ligaments were less detectable and thinner in patients affected by RA compared with healthy volunteers matched for age and sex. Ligament thinning did not directly correlate with RA duration and clinical parameters.
  
  
  CONCLUSIONS
  • Ultrasound is increasingly used to evaluate normal anatomy of extrinsic wrist ligaments.                                                  • Extrinsic wrist ligaments are thinner in rheumatoid arthritis patients than in controls.                                                  • Extrinsic wrist ligaments are less easy to detect in rheumatoid arthritis patients.                                                  • Ligament thinning and detectability are not related to clinical parameters.
authors.affiliation: Servizio di Radiologia, IRCCS Policlinico San Donato, Via Morandi 30, 20097, San Donato Milanese, Milan, Italy. io@lucasconfienza.it
authors.forename: Luca Maria
authors.initials: LM
authors.lastname: Sconfienza
authors.forename: Enzo
authors.initials: E
authors.lastname: Silvestri
authors.forename: Marco Amedeo
authors.initials: MA
authors.lastname: Cimmino
mesh_terms: D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*; D014955:Wrist Joint / Q000000981:diagnostic imaging*