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Egyptian Rheumatology and Rehabilitation
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Ultrasonographic findings of the shoulders in Egyptian patients with rheumatoid arthritis

Egyptian Rheumatology and Rehabilitation volume 44, pages 17–23 (2017)Cite this article

Abstract

Objective

This study aimed to highlight the diagnostic value of musculoskeletal ultrasonography (US) in the evaluation of inflammatory changes in the shoulders of rheumatoid arthritis (RA) patients and to correlate those findings with the clinical, laboratory, and radiological parameters of the disease activity.

Patients and methods

This study included 40 RA patients diagnosed according to the 2010 American College of Rheumatology/European League Against Rheumatism classification criteria for RA. In addition, 20 age-matched and sex-matched healthy individuals were included. US assessment was performed bilaterally in RA patient’s shoulder and unilaterally in controls. All US examinations were carried out using LOGIQ P6 PRO machine equipped with 6–8 MHz broadband multifrequency linear transducer.

Result

US on shoulders detected that 21 (52.5%) RA patients studied had erosions, 18 (45%) RA patients had synovitis, 21 (52.5%) RA patients had tenosynovitis, seven (17.5%) RA patients had bursitis, and 18 (45%) RA patients had rotator cuff tendinopathy. There was a significant relation between US-detected erosion in RA patients and disease duration (P = 0.037) and rheumatoid factor (RF) level (P = 0.02), whereas there was no significant relation between US-detected erosion in RA patients and shoulder pain (P = 0.185), Disease activity score 28 (DAS28) (P = 0.163), erythrocyte sedimentation rate (P = 0.519), and C-reactive protein levels (P = 0.561). There was a significant relation between US-detected tenosynovitis in RA patients and shoulder pain (P = 0.025). There was no significant relation between US-detected bursitis in RA patients and disease duration (P = 0.970), shoulder pain (P = 0.907), DAS28 (P = 0.471), erythrocyte sedimentation rate (P = 0.220), and RF levels (P = 0.755), whereas there was a significant relation between US-detected bursitis in RA patients and C-reactive protein (P = 0.036).

Conclusion

US became a problem-solving approach and the tool of choice for cases with shoulder problem, and can provide an accurate answer to many clinical questions and give an accurate diagnosis of different pathological abnormalities encountered.

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Authors and Affiliations

  1. Department of Rheumatology, Physical Medicine and Rehabilitation, Benha University, Shebin El Kanater, Benha, Qalubia, 013320280, Egypt

    Ali Ibrahim Fuda & Nashwa Ismail Hashaad MD

  2. Department of Diagnostic Radiology, Benha University, Benha, Egypt

    Osama Galal

  3. Faculty of Medicine, Benha University, Benha, Egypt

    Osama Galal & Afaf Mahmoud Azzam

Authors
  1. Ali Ibrahim Fuda
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  2. Nashwa Ismail Hashaad MD
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  3. Osama Galal
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  4. Afaf Mahmoud Azzam
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Correspondence to Nashwa Ismail Hashaad MD.

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Fuda, A.I., Hashaad, N.I., Galal, O. et al. Ultrasonographic findings of the shoulders in Egyptian patients with rheumatoid arthritis. Egypt Rheumatol Rehabil 44, 17–23 (2017). https://doi.org/10.4103/1110-161X.200836

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  • DOI: https://doi.org/10.4103/1110-161X.200836

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