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Revista Colombiana de Reumatología

Print version ISSN 0121-8123

Abstract

CALDERON-CORDERO, Carlos et al. Ultrasound findings in hand and foot joints of asymptomatic volunteers. Rev.Colomb.Reumatol. [online]. 2019, vol.26, n.3, pp.165-176.  Epub Aug 20, 2020. ISSN 0121-8123.  https://doi.org/10.1016/j.rcreu.2019.07.001.

Introduction:

Ultrasound (US) abnormalities have often been described in the joints of asymptomatic subjects, which may lead to uncertainty in the evaluation and treatment of inflammatory joint disease. Despite this, the available evidence is scarce, with few participants, and in the vast majority with transducers less than 18Mhz. In Colombia there are currently no published studies about this topic.

Objectives:

To describe the ultrasound findings in hand and foot joints in asymptomatic volunteers, their association with sociodemographic characteristics, and intra- and inter-observer concordance of the measurements.

Materials and methods:

Descriptive and analytical study within 182 asymptomatic volunteers. Two physicians with musculoskeletal ultrasound experience evaluated the dorsal aspect of 5460 articular recesses using the semi-quantitative scale of Szkudlarek using a 18 MHz linear transducer.

Results:

The median age of the participants was 42 years, including 60.4% women. A total of 232 abnormal findings were identified in 87% of the volunteers, with 68.1% corresponding to joint effusion, 29.3% synovial hypertrophy, 2.1% erosions, and 0.4% positive power Doppler. The feet evaluation showed more findings than the hands (70.7 vs. 29.3%). The joints in which most abnormalities were identified were the first metatarsophalangeal joint (52%), third metatarsophalangeal joint (15%), and radiocarpal joint (9.5%). A positive association was found between joint effusion and synovial hypertrophy with age, exclusive manual activity, and occupation for more than ten years. The intra-observer concordance was moderate (Kappa = .4591) and the inter-observer was low (Kappa = .2155).

Conclusions:

The absence of power Doppler signal, the absence of abnormalities in distal radioulnar, the absence of synovitis accompanied by erosion, and a greater predominance of mild alterations in the hand joints, added to the absence of findings in the fifth metatarsal joint, can be potential specific findings of asymptomatic subjects and might be confirmed in future studies.

Keywords : Musculoskeletal ultrasound; Joint effusion; Synovial hypertrophy; Synovitis; Power Doppler; Erosions; Asymptomatic volunteers.

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