US has much to offer in the study of rheumatoid arthritis in spite of the relative lack of scientific reports on the subject. The main drawbacks to research in this field include the current limited availability of very high resolution probes together with the lack of standardized US criteria for cartilage involvement.
In rheumatoid patients, US can visualize pre-erosive changes, particularly at the level of the metacarpophalangeal joint, together with loss of the cartilage layer and irregularities of the sub-chondral bone (Figs. 4.4,4.5) [3,12].
Rheumatoid arthritis. Longitudinal dorsal scan of a metacarpophalangeal joint shows proliferative synovitis with early erosive changes.Complete loss of the cartilage layer of the metacarpal head with initial subchondral involvement (arrowhead). m = metacarpal head; p = proximal phalanx; t = extensor tendon
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