Musculoskeletal ultrasonography versus conventional radiography: Correlation with DAS28 and MDHAQ scores in early rheumatoid arthritis

Objectives To compare the value of musculoskeletal ultrasound (MSUS) with conventional radiography in the detection of patients with early rheumatoid arthritis (RA) and to correlate the sonographic findings with disease activity, and functional disability scores. Methods Patients >18 years of age with RA ≤2 years who satisfied the 2010 EULAR/ACR classification criteria for rheumatoid arthritis and disease activity score 28 (DAS28) >2.6, were enrolled. Plain radiographs and MSUS examinations were performed on 18 joints bilaterally. DAS28 and multi-dimensional health assessment questionnaire (MDHAQ/RAPID) scores were assessed. Results Forty patients (35 women, 5 men), mean age 41 ± 12 years, and mean disease duration 11 ± 5 months, were included. In total, 720 joints were examined. The number of hand joints affected by erosions via MSUS was 3.28-fold the number detected by X-ray. Sonographic evidence of synovitis and active erosion significantly correlated with MDHAQ, DAS28 and inflammatory biomarkers. Conclusion Joint sonography was superior to conventional radiography in early detection of structural joint damage and active disease in patients with early RA which correlated with disease activity and functional ability scores.