Background Proliferative synovitis is very common finding in patients with rheumatoid arthritis (RA). Among imaging methods ultrasound is very useful instrument for detection of synovial abnormalities. Using this method we can measure thickness of synovium, it’s morphology and localisation. During examination we also can detect joint effusion in knee and presence of Baker’s in popliteal fossa. As a sign of synovial inflammation we can detect enhanced blood flow in proliferated synovium.

Objectives The aim of our study was to detect and measure the thickness of synovial proliferated tissue in suprapatellar recess and to try to find correlation between this finding and disease activity. We also used power doppler to observe blood flow in small vessels of synovial tissue.

Methods In our study we included 20 patients with clinically affected both knees. Using modern equipment for ultrasound examination (Acceuson Sequoia 5–8 MHz with power doppler), we measured thickness of the synovium in the middle of suprapatellar recess in longitudinal approach. We also detected presence of joint effusion as well as Baker’s cyst in popliteal fossa. Disease activity was estimated by sedimentation rate.

Results We found the thickness of synovial tissue range 1, 3–6 mm (X average = 3,6 mm). Joint effusion was presented in all patients. In 46% of patients we found Baker’s cyst with the same synovial pattern. Sedimentation rate in our patients was ranged 19–110/h. We didn’t find any significant correlation between synovial thickness and such estimated disease activity. We also found presence of extensive blood flow in small vessels of synovium.

Conclusion Ultrasound is very objective instrument for detection and measuring of synovial proliferation. This information is useful for practicioner to indicate corticosteroidal injections, synoviorthesis or surgical synovioctomy. This method is also necessary to estimate the results of those procedures.

References

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