CC BY-NC-ND 4.0 · Ultrasound Int Open 2018; 04(02): E61-E68
DOI: 10.1055/a-0612-7852
Original Article
Eigentümer und Copyright ©Georg Thieme Verlag KG 2018

The Value of an Automated Ultrasound System in the Detection of Synovitis

Ruediger Mueller
1  Division of Rheumatology, Kantonsspital St. Gallen, St. Gallen, Switzerland
2  Munich University Hospital, Division of Rheumatology, Munich, Germany
,
Mathias Grunke
2  Munich University Hospital, Division of Rheumatology, Munich, Germany
,
Jörg Wendler
3  Schwerpunktpraxis Rheumatologie, Rheumatologie, Erlangen, Germany
,
Florian Schuch
4  Schwerpunktpraxis Rheumatologie, Schwerpunktpraxis Rheumatologie, Erlangen, Germany
,
Karina Hofmann-Preiss
5  Institut für bildgebende Diagnostik und Therapie, BDT - MVZ Träger GmbH, Erlangen, Germany
,
Ina Boettger
5  Institut für bildgebende Diagnostik und Therapie, BDT - MVZ Träger GmbH, Erlangen, Germany
,
Rüdiger Jakobs
6  Siemens Healthcare GmbH, Ultrasound, Erlangen, Germany
,
Hendrik Schulze-Koops
2  Munich University Hospital, Division of Rheumatology, Munich, Germany
,
Johannes von Kempis
1  Division of Rheumatology, Kantonsspital St. Gallen, St. Gallen, Switzerland
› Author Affiliations
Further Information

Publication History

received 12 August 2016
revised 15 February 2018

accepted 02 April 2018

Publication Date:
11 July 2018 (online)

Abstract

Background The detection of joint swelling caused by synovitis is important for the diagnosis of inflammatory arthritis. Ultrasound (US) and MRI have proven to be more sensitive and reliable than physical examination, but they are time-consuming and expensive. The automated breast volume scanner was developed to acquire serial B-mode pictures of the female breast and these can be analyzed in all three dimensions.

Objectives To analyze the value of automated B-mode ultrasound employing the ABVS system in detecting synovitis of the finger joints compared to manual ultrasound (mUS) and physical examination, using MRI as the gold standard.

Methods 19 consecutive patients suffering from active rheumatoid (n=15) or psoriatic (n=4) arthritis were included. Automated and mUS were conducted with a linear array (ACUSON S2000™, 11 MHz). Multiplanar reconstruction enabled examination of the images for the presence of synovitis.

Results 90% of the hand joints were assessable by automated ultrasound. Automated US detected 12.0, mUS 14.2, MRI 13.4, and clinical examination 4.1 positive joints – i. e. joints with synovitis - on average per patient. The inter-observer reliability of both assessors for automated and mUS, MRI, and physical examination, was 66.9%, 72.7%, 95.1%, and 88.9%, respectively. 84.3% of the joints classified as positive on MRI were confirmed by automated ultrasound, 85.5% on mUS, and 36.0 on physical examination. This translated into a sensitivity of 83.5%, 85.5%, and 36.0% for the three methods, respectively. Conclusion: Automated ultrasound is a promising ultrasound method for assessing small joints in patients with inflammatory arthritis.

Supporting Information