Comparison the percentage of detection of periarthritis in patients with rheumatoid arthritis using clinical examination or ultrasound methods.
BACKGROUND
This study aimed to compare the percentage of detection of periarthritis in patients with rheumatoid arthritis using clinical examination and ultrasound methods.


METHODS
This study is a cross-sectional study which was conducted in Al-Zahra Hospital (Isfahan, Iran) during 2014-2015. In our study, ninety patients were selected based on the American College of Rheumatology 2010 criteria. All patients were examined by a rheumatologist to find the existence of effusion, and the data were filled in the checklist. The ultrasonography for detecting effusion in periarticular structures was done by an expert radiologist with two methods, including high-resolution ultrasonography and power Doppler. The percentage of effusion existence found by physical examination was compared by sonography, and the Chi-square andt-tests were used for data analysis.


RESULTS
The percentage of effusion found in areas with physical examination by rheumatologist was lower than the frequency distribution of effusions found by sonography (8.3% VS 14.2%) (P< 0.001). In sonography, rotator cuff tendonitis is the most common periarthritis. Other findings in sonography were biceps tendinitis (10 cases), wrist tendonitis (13 cases), olecranon bursitis (9 cases), golfers elbow (4 cases), tennis elbow (4 cases), trochanteric bursitis (6 cases), anserine bursitis (6 cases), prepatellar bursitis (11 cases), and ankle tendonitis (7 cases). Tenderness on physical examination was found in 15% of the cases, and the evidence of periarthritis was found in 21/7% through sonography (P< 0.001) and 34% through Doppler sonography (P< 0.001).


CONCLUSIONS
The percentage of periarthritis detection by ultrasonography and power Doppler sonography was higher than clinical examination. Hence, the ultrasonography is more accurate than physical examination.
Department of Rheumatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Hadi
H
Karimzadeh
Department of Rheumatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Zahra
Z
Seyedbonakdar
Department of Rheumatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Maryam
M
Mousavi
Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Mehdi
M
Karami
Periarthritis; rheumatoid arthritis; ultrasonography