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Rheumatoid Hand Joint Synovitis: Gray-Scale and Power Doppler US Quantifications Following Anti–Tumor Necrosis Factor– Treatment: Pilot Study¹

¹ From the Department of Rheumatology, Center for Cellular and Molecular Therapy (C.R., B.A., O.K., L.M., V.B., M.G.M.), Department of Bone and Joint Radiology (S.M.), and Department of Nuclear Medicine (C.B.), University Hospital of Liège, Room 155 BC + 3, CHU Sart-Tilman B35, B-4000 Liège, Belgium. Received March 5, 2002; revision requested May 22; final revision received January 14, 2003; accepted February 24. Address correspondence to C.R. (e-mail: clio.ribbens@ulg.ac.be).

View larger version (145K): [in a new window]   Figure 1. B-mode US synovial thickness measurements in an MCP joint, scanned in a sagittal plane of the dorsal surface, at baseline (A) and 6 weeks after infliximab treatment (B) show decrease in synovial thickness: from 4.8 to 4.1 mm (calipers). Synovial measurements were performed perpendicular to the great axis and at the point of greatest thickness. Bone contours depicted in A and B may appear slightly different because measurements were performed according to standardized anatomic landmarks (described in Materials and Methods) and at week 6 were performed without access to the baseline results.

View larger version (148K): [in a new window]   Figure 2. Sagittal power Doppler US images of a wrist of one patient at baseline (A) and 6 weeks after infliximab treatment (B) show disappearance of the Doppler signal (red area) after treatment (score 2 before treatment). Bone contours in A and B may appear slightly different because US was performed according to standardized anatomic landmarks (as described in Materials and Methods) and at week 6 was performed without access to the baseline results.

View larger version (34K): [in a new window]   Figure 3. Graph shows positive linear correlation between changes in cumulative synovial thickness (sum of synovial thickness in all hand joints evaluated per patient) from baseline (ie, baseline - week 6 values) and changes in DAS22 (ie, DAS integrating erythrocyte sedimentation rate, patient’s global assessment of disease activity, and number of swollen and tender joints in 22 hand joints per patient) from baseline.