Ultrasound features of nonstructural lesions of the proximal and distal interphalangeal joints of the hands in patients with finger osteoarthritis.

OBJECTIVES: To describe the ultrasound features of nonstructural damage (effusions, synovitis, Doppler signal abnormalities) in the proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints of the fingers in patients with finger osteoarthritis compared to healthy controls. METHODS: We included patients at a hospital-based outpatient rheumatology clinic who met American College of Rheumatology criteria for finger osteoarthritis and we compared them to healthy controls. Exclusion criteria were the same in both groups. We collected demographic data and symptoms. Ultrasonography (Esaote Technos machine, two sonographers) was performed in all participants in both groups and plain radiography in the patients only. The PIP and DIP joints on fingers 2 to 5 were evaluated. Ultrasound features were compared between the two groups. RESULTS: We included 55 patients (51 women; 440 PIPs and 440 DIPs) and 46 healthy controls (368 PIPs and 368 DIPs). The rate of PIP joint effusion was similar in the two groups (patients, 2.05±2.03; controls, 1.6±1.7; P>0.05), whereas the rate of DIP effusion was significantly higher in the patients (2.09±1.87 versus 0±0.6 in the controls; P<0.05). Increased vascularization by Doppler evaluation was rare and occurred chiefly in the DIP joints of the patients. None of the participants in either group had synovitis. The ultrasound abnormalities were not significantly different between right- and left-handed individuals, and neither did they correlate with clinical disease expression or severity of the radiographic damage.

High frequency of ultrasonographic effusion in interphalangeal joints of healthy subjects: a descriptive study.

OBJECTIVE: To describe echographic abnormalities on the proximal (PIP) and distal (DIP) interphalangeal joints of healthy subjects. METHODS: Healthy asymptomatic volunteers under forty were enrolled. Ultrasonography was performed on PIP and DIP 2-5 in the presence of two operators. In B mode, synovial hypertophy and effusion were defined with the OMERACT criteria. In power Doppler mode, the inflammatory activity was evaluated. RESULTS: 46 subjects were enrolled: mean age 25.5 years, 89% right handed. 368 PIPs and DIPs were scanned. Effusion was found in 19.6% of dominant PIPs versus 22.3% of non-dominant PIPs (p>0.05). Effusion could be uni- or bilateral. DIP effusion was less frequent (3% DIPs). Average size of effusion was 0.83+/-0.25 mm for PIP and 0.72+/-0.16 mm for DIP. CONCLUSION: Our study proposes a descriptive analysis of the PIP and the DIP joints. It confirms, with a bigger number of studied joints, the possible existence of a physiological effusion of the PIP of healthy subjects. It is the first descriptive study of the normal DIP where the presence of an effusion is very rare.