Power Doppler ultrasound assessment of rheumatoid hand synovitis

Objective. To evaluate power Doppler ultrasound (PD) as a technique in asse ssing response to treatment with steroids in rheumatoid hand synovitis. Methods. Twelve patients with rheumatoid hand synovitis were assessed befor e and after treatment with steroids. Variables used to assess synovitis act ivity in each patient included patient visual analog scale (VAS) score for pain, physician assessment score (PAS), erythrocyte sedimentation rate (ESR ), and PD of the metacarpophalangeal joints. Results. Nine female and 3 mate patients were studied; mean age was 53.3 +/ -6.5 yrs and mean disease duration 6.5 +/-4.5 yrs. All patients had a good clinical response to steroid treatment and there was a significant improvem ent in the synovitis activity assessments. Wilcoxon signed-rank test using the exact method was applied to the change in disease activity variables. F or PD signal, p<0.002; VAS, p<0.0016; ESR, p<0.031; PAS, p<0.008. Conclusion. PD quantifies synovitis and may be a useful adjunct to disease assessment and the response to treatment in RA.