الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
RA is the most common inflammatory arthritis, affecting approximately 1% of the world’s population. It is characterized by proliferative, hyper vascularized synovitis and osteitis, resulting in bone erosion, cartilage damage, joint destruction, and long-term disability.
Over the last two decades, significant improvement in its prognosis has been achieved owing to new strategies for disease management. The emergence of new biologic therapies and better utilization of conventional disease-modifying antirheumatic drugs also helped in that improvement. Prompt diagnosis and appropriate therapy have been recognized as essential for improving clinical outcomes in patients with early RA.
Diagnosis of RA is based on clinical, laboratory and radiographic findings. Conventional radiography has been the primary imaging modality of choice in RA because of its reproducibility and feasibility with respect to detecting structural damage. However, radiography can provide only indirect information on synovial inflammation, and the technique is insensitive to early inflammatory bone involvement and bone damage.
Until recently, the absence of effective treatment to prevent joint destruction has limited the need for more sensitive imaging techniques. This situation changed after the development of new therapeutics for RA, such as anti-tumor necrosis factor (TNF) agents.
The availability of these potent and expensive drugs has created new demands for radiologists to identify patients with aggressive RA at an early stage.
(MRI) and (US) are increasingly being used in the assessment of RA in research and clinical practice. They are able to provide insight into the pathogenesis of inflammatory joint disease and ability to identify the key pathologic features of this disease entity at presentation, much earlier than they are seen on radiography.
Both modalities are characterized by high sensitivity in depicting local inflammation in the form of synovitis, tenosynovitis and bursitis. Their sensitivity is greater than in clinical examination and conventional radiography and can help establish an early diagnosis in RA.
Consequently, this study was conducted and aimed to facilitate diagnosis and; to detect the complications of the rheumatoid arthritis by noninvasive, painless, cheap method and by using non ionizing radiation.
This comparative accuracy testing, prospective study was conducted at Radio diagnosis Department, Faculty of Medicine, Ain Shams University Hospitals from February 2022 until February 2023.
During this study, 20 patients with clinically and laboratory proven rheumatoid arthritis were enrolled after consenting of them and subjected to ultrasound and MRI examination to compare between them in prediction of synovitis, tenosynovitis, joint effusion, bone marrow oedema, bone erosion and power Doppler activity.
To the best of our knowledge, there are no studies in literature assessing our study outcomes and most of studies that disagreed with our results were due to several causes as different study methodology, outcomes, sample size and different degree of medical conditions of studied cases at time of enrollment.
Our study revealed that MRI was more accurate than ultrasound in assessment of bone marrow edema.
On the other hand and as regard Doppler activity, ultrasound was more accurate than MRI.
Finally, no differences were detected between both modalities in detection of synovitis, tenosynovitis, joint effusion and bone erosion.
In conclusion, ultrasound and MRI are synergistic to each other in assessment of articular affection of rheumatoid arthritis as MRI was more accurate than ultrasound in assessment of bone marrow edema. If possible, ultrasound is advised to be used in assessment, diagnosis and detection of the complications of rheumatoid arthritis. It is noninvasive, painless, cheap method without using of ionizing radiation. MRI is advised to be limited and performed in certain cases who need assessment of bone marrow edema. The present study can burden the knowledge and shed some light on future prospective studies with larger sample sizes to reassess and confirmation of our results and conclusions.