الفهرس 
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Abstract
Rheumatoid arthritis (RA) is an inflammatory rheumatic disease with progressive course affecting articular and extra-articular structures resulting in pain, disability and mortality. Persistent inflammation leads to erosive joint damage and functional impairment in the vast majority of patients. The onset of disease is not similar in all patients but varies in regard to type, number, and the pattern of joint involvement. The course of disease may be also different according to the presence or absence of several variables including genetic background, frequency of swollen joints, autoantibody in the serum and the severity of inflammatory process.
Identification of RA at initial presentation and treatment at earlier stage can affect disease course, prevent the development of joint erosions or retard progression of erosive disease. Early diagnosis and treatment may affect disease outcomes even to a remission state.
Ultrasound imaging is currently a commonly acknowledged and widely used method in the diagnosis of Rheumatoid arthritis. In recent years, it has become an essential supplement of physical examination in Rheumatologist practice.
Ultrasound and Power Doppler have additional value to clinical examination both in improving early diagnosis of RA and establishing true RA remission. It’s an easy, non invasive technique with no radiation exposure.
US & PD are highly sensitive in detecting early synovial hypertrophy, effusion, activity, tenosynovitis and any early minimal erosions.
The aim of this study was to demonstrate the role of Ultrasonography and Power Doppler in early diagnosis of rheumatoid arthritis in the hands and wrist joints among different aged population, compared with the laboratory investigations.
In our study, 27 patients of the total 30 were positive for Rheumatoid Arthritis by US & PD with sensitivity and specificity of 100%.
from our study the following conclusion can be derived:
US & PD are highly sensitive and specific in early detection of the Rheumatoid Arthritis similar to laboratory investigations. So, they can be used as early, non invasive methods in detection of early RA changes in wrist and hand joints