Iva Žagar

AB1292 Patological changes of shoulder joint in early phase of rheumatoid arthritis detected by ultrasound, magnetic resonance imaging and power doppler

Objectives The primary objective of the study was to establish the status of rotator cuff in the early rheumatoid arthritis (RA) using shoulders ultrasonography (US), Power Doppler (PD) and MRI. The other specific objective was to detect other inflammatory changes of shoulder joint such as erosions, synovitis, effusion, bursitis and humeral head bone oedema. Methods The prospective study was conducted at the Clinical Department of Rheumatology and Rehabilitation, Clinical Hospital Center Zagreb, in the group of 50 patient who fullfiled criteria for diagnosis of RA. The study was conducted by US machine Logiq 700, using 7-11 MHz high-resolution linear probe (General Electric). MRI of shoulder joints was performed using machine: Siemens Magnetom Trio, with 3T magnetic field. Results All three methods were effective in detecting early inflammatory changes. MRI of shoulder was the most accurate method in discovering the humeral head bone oedema. US and MRI of shoulders had very good results in detecting early rotator cuff changes. Rotator cuff tears were found in 7 patients (14%) using US and in 11 patients (24%) using MRI. The highest number of tears were found in the site of supraspinatus tendons (in 5 out of 7 patients using US and in 8 out of 11 patients by MRI). US and MRI showed the highest correlation between findings in the way of detecting rotator cuff tears (correlation index 88%, kappa value=0,598 which is the highest kappa value in the study). US and MRI are efficient in detecting effusions and bursitis. PD of shoulder was the superior method in detecting synovitis with the highest number of positive findings (90%) in comparison to standard US and MRI. Conclusions Those data emphasize the importance of US, PD and MRI of shoulder in detecting early inflammatory changes in the patients with RA, especially of rotator cuff tears using US and MRI and detecting humeral bone oedema using MRI. Disclosure of Interest None Declared