Background The detection of joint swelling is a key feature in the diagnosis and assessment of arthritic diseases. Ultrasound and MRI have proven to be more sensitive and reliable than clinical examination, but a comprehensive examination of the small joints with these techniques is either time consuming or expensive. The automated breast volume scanner (ABVS) was developed to acquire series of consecutive B-mode pictures of the female breast and these data can be analysed in all three dimensions.
Objectives To analyse the value of ABVS in detecting swelling of the finger joints compared to clinical examination and manual ultrasound.
Methods 19 consecutive patients suffering from psoriatic (n=4) or rheumatoid (n=15) arthritis with at least 1 swollen MCP (metacarpophalangeal) or PIP (proximal interphalangeal) joint were included. ABVS and manual ultrasound were conducted using the ACUSON S2000™ (Siemens Medical Solutions, Mountain View, USA). The ABVS transducer was equipped with a linear array (5 – 14 MHz band width); the frequency was set at 11 MHz. Each automatic sweep of the scanner generated 15.4 x 16.8 cm x maximum 3 cm volume data sets. The system was set to perform an automatic scanning time of 65 s per scan with a slice thickness of 0.5 mm. The dorsal and palmar side of each hand were scanned separately. Multiplanar reconstruction enabled examination of the images at multiple levels for the presence of lesions or joint swelling (figure)
Results Clinical examination of MCP, PIP, and DIP joints detected in average 4.1 swollen joints, manual ultrasound 13.7 joints, and ABVS 10.6 joints per patient. The interobserver reliability for detection of joint swelling were 73.3%, 72.5% and 85.9% for manual ultrasound, ABVS, and clinical examination, respectively. The sensitivities and specificities were 30.7% and 91.3% for clinical examination and 59.9% and 63.4% for ABVS using manual ultrasound as gold standard.
Conclusions ABVS is a simple and time sparing option for effective detection of joint swelling in patients suffering from arthritis with good sensitivity and specificity compared to manual ultrasound.
Disclosure of Interest None Declared
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