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High-resolution ultrasound of the midfoot: sonography is more sensitive than conventional radiography in detection of osteophytes and erosions in inflammatory and non-inflammatory joint disease

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Abstract

This study aimed to compare the diagnostic value of ultrasonography to conventional radiography in detecting osteophytes and erosions in the midfoot joints in patients suffering from inflammatory and non-inflammatory joint disease. Patients with current foot radiographs were included and stratified in two cohorts: inflammatory and non-inflammatory joint disease. The ten midfoot joints of each foot were evaluated by conventional radiography assessing the presence of osteophytes and erosions and by ultrasonography determining the presence of osteophytes, erosions, and joint effusion. Power Doppler activity was scored semi-quantitatively from 0 to 3. A total of 2445 joints in 124 patients (90 with inflammatory joint disease, 34 with non-inflammatory joint disease) were assessed. Ultrasonography detected significantly more osteophytes than conventional radiography (344; 14.1% vs. 13; 0.5%), as well as more erosions (60; 2.5% vs. 3; 0.1%). There was weak agreement between the two modalities (κ-statistic 0.029–0.035). Power Doppler ultrasonography demonstrated no significant difference in hyperperfusion comparing patients with inflammatory joint disease and non-inflammatory joint disease. Ultrasonography of the midfoot is more sensitive than conventional radiography in the detection of osteophytes and erosions in patients suffering from inflammatory and non-inflammatory joint disease. Thus, midfoot ultrasonography may be a useful tool in the diagnosis of joint diseases as rheumatoid arthritis and osteoarthritis.

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References

  1. Mathiessen A, Haugen IK, Slatkowsky-Christensen B, Boyesen P, Kvien TK, Hammer HB (2013) Ultrasonographic assessment of osteophytes in 127 patients with hand osteoarthritis: exploring reliability and associations with MRI, radiographs and clinical joint findings. Ann Rheum Dis 72:51–56

    Article  PubMed  Google Scholar 

  2. Szkudlarek M, Narvestad E, Klarlund M, Court-Payen M, Thomsen HS, Ostergaard M (2004) Ultrasonography of the metatarsophalangeal joints in rheumatoid arthritis: comparison with magnetic resonance imaging, conventional radiography, and clinical examination. Arthritis Rheum 50:2103–2112

    Article  PubMed  Google Scholar 

  3. Wakefield RJ, Gibbon WW, Conaghan PG, O’Connor P, McGonagle D, Pease C et al (2000) The value of sonography in the detection of bone erosions in patients with rheumatoid arthritis: a comparison with conventional radiography. Arthritis Rheum 43:2762–2770

    Article  CAS  PubMed  Google Scholar 

  4. Backhaus M, Burmester GR, Sandrock D, Loreck D, Hess D, Scholz A et al (2002) Prospective two year follow up study comparing novel and conventional imaging procedures in patients with arthritic finger joints. Ann Rheum Dis 61:895–904

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Sant’Ana Petterle G, Natour J, Rodrigues da Luz K, Soares Machado F, dos Santos MF, da Rocha Correa Fernandes A et al (2013) Usefulness of US to show subclinical joint abnormalities in asymptomatic feet of RA patients compared to healthy controls. Clin Exp Rheumatol 31:904–912

    PubMed  Google Scholar 

  6. Barr AJ, Campbell TM, Hopkinson D, Kingsbury SR, Bowes MA, Conaghan PG (2015) A systematic review of the relationship between subchondral bone features, pain and structural pathology in peripheral joint osteoarthritis. Arthritis Res Ther 17:228

    Article  PubMed  PubMed Central  Google Scholar 

  7. Muraki S, Akune T, Nagata K, Ishimoto Y, Yoshida M, Tokimura F (2015) Does osteophytosis at the knee predict health-related quality of life decline? A 3-year follow-up of the ROAD study. Clin Rheumatol 34:1589–1597

    Article  PubMed  Google Scholar 

  8. Keen HI, Wakefield RJ, Grainger AJ, Hensor EM, Emery P, Conaghan PG (2008) Can ultrasonography improve on radiographic assessment in osteoarthritis of the hands? A comparison between radiographic and ultrasonographic detected pathology. Ann Rheum Dis 67:1116–1120

    Article  CAS  PubMed  Google Scholar 

  9. Wittoek R, Carron P, Verbruggen G (2010) Structural and inflammatory sonographic findings in erosive and non-erosive osteoarthritis of the interphalangeal finger joints. Ann Rheum Dis 69:2173–2176

    Article  PubMed  Google Scholar 

  10. Wakefield RJ, Balint PV, Szkudlarek M, Filippucci E, Backhaus M, D'Agostino MA et al (2005) Musculoskeletal ultrasound including definitions for ultrasonographic pathology. J Rheumatol 32:2485–2487

    PubMed  Google Scholar 

  11. Backhaus M, Ohrndorf S, Kellner H, Strunk J, Backhaus TM, Hartung W et al (2009) Evaluation of a novel 7-joint ultrasound score in daily rheumatologic practice: a pilot project. Arthritis Rheum 61:1194–1201

    Article  CAS  PubMed  Google Scholar 

  12. Chan PS, Kong KO (2013) Natural history and imaging of subtalar and midfoot joint disease in rheumatoid arthritis. Int J Rheum Dis 16:14–18

    Article  PubMed  Google Scholar 

  13. Patel A, Rao S, Nawoczenski D, Flemister AS, DiGiovanni B, Baumhauer JF (2010) Midfoot arthritis. J Am Acad Orthop Surg 18:417–425

    Article  PubMed  Google Scholar 

  14. Thomas MJ, Peat G, Rathod T (2015) The epidemiology of symptomatic midfoot osteoarthritis in community-dwelling older adults: cross-sectional findings from the Clinical Assessment Study of the Foot. Arthritis Res Ther 17:178

    Article  PubMed  PubMed Central  Google Scholar 

  15. Colebatch AN, Edwards CJ, Ostergaard M, Van der Heijde D, Balint PV, D'Agostino MA et al (2013) EULAR recommendations for the use of imaging of the joints in the clinical management of rheumatoid arthritis. Ann Rheum Dis 72:804–814

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors would like to thank all participating patients who made this study possible.

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Correspondence to Wolfgang Hartung.

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The study has been approved by the local ethics committee and has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Furthermore, all patients gave written informed consent prior to their inclusion in the study.

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Camerer, M., Ehrenstein, B., Hoffstetter, P. et al. High-resolution ultrasound of the midfoot: sonography is more sensitive than conventional radiography in detection of osteophytes and erosions in inflammatory and non-inflammatory joint disease. Clin Rheumatol 36, 2145–2149 (2017). https://doi.org/10.1007/s10067-017-3658-x

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  • DOI: https://doi.org/10.1007/s10067-017-3658-x

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