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A Journal on Forensic Medicine
Minerva Medicolegale 2002 September;122(3): 115-20
The clinical and ultrasound stages of phalangeal joint damage in psoriatic and rheumatoid arthritis
Iurassich S., Pedana M. A., Cioce F.
Background. Psoriatic and rheumatoid arthritis evidence bone and inflammatory damage that generates functional limitation of the fingers which is shown up in ultrasonography (US). Assessment of this damage is expressed as a percentage and depends on the subjective interpretation of the specialist. For this reason we have compared US findings with the percentage assessment figures and plotted a graph for interpretation purposes.
Methods. 64 patients with phalangeal joint suffering due to psoriatic arthritis (26 cases) and rheumatoid arthritis (38 cases) were studied. US investigation of the skin and phalangeal joints of the fingers was carried out using the Sonora Logic 400 MD echograph (GE, Milwau-kee, USA) and 7.5 and 10 MHz probes. In each patient the functional limitation of the fingers was assessed and expressed in the form of percentages and evidenced at objective examination and with US values of inflammatory and bone damage to the skin and phalangeal joints.
Results. The values expressed as percentages correlated with the US values describe a graph that makes it possible to divide the gravity of the functional limitation of the fingers into 4 clinical/ultrasound stages.
Conclusions. US signs of bone and inflammatory damage are easy to read in the images and make it possible to confirm the diagnosis and assess the treatment, whereas the graph and the 4 clinical/ultrasound stages can help the specialist to quantify the bone and inflammatory damage suffered.