Validity of radiological methods in early detection of rheumatoid shoulder synovitis and correlation with disease activity

الملخص EN

Subjects & Methods: This study was carried out on 34 active rheumatoid arthritis (RA) patients.

All studied cases were subjected to careful history, clinical and joint examination, routine laboratory investigations and Interleukin –1? (IL-1?) level determination.

Twenty-seven patients who had painful shoulders were radiologically examined with PR, US, CT and MRI with quantitative evaluation of bone erosions and joint space narrowing to assess disease activity.

Results: Positive correlations were found between IL-1? and Ritchie articular index (RAI), ESR, disease activity score (DAS) and RF in all patients (p=0.007, <0.05, = 0.007 and <0.001 respectively).

Radiologically, glenohumeral erosions were detected with PR in 15-patients (55.5 %), with US in 21 patients (77.7 %), with CT in 15 patients (55.5 %) and with MRI in 19 patients (70.3%).

US was the most sensitive in detecting erosion of the glenohumeral articulations (77.7%) while MRI was more sensitive in acromioclavicular erosions, as well as major & minor tuberosities (81.4% and 88.8% respectively ).

Grading of these erosions was done with the 4 modalities effusion and rotator cuff tear was detected with US in 25.9% and with MRI in 33.3%.

Pannus was only detected with MRI.

Total scores for bone erosions and joint space narrowing showed significantly positive correlations with serum levels of IL-1? in our patients.

(p<0.001 and 0.005 respectively).

Conclusion: All four radiological modalities are complementary in the diagnosis and monitoring of rheumatoid shoulder patients and there is a positive correlation between these radiographic scoring methods and the clinical and laboratory parameters of disease activity.