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Arthritic Bone Erosions Can Be Detected by Ultrasound

False-negative ultrasound results uncommon, but more false-positives seen than with micro-CT

FRIDAY, May 13 (HealthDay News) -- Most arthritic bone erosions seen on ultrasound (US) imaging are cortical breaks, which are detected on micro-computed tomography (micro-CT) scans, according to a study published in the May issue of Arthritis & Rheumatism.

Stephanie Finzel, M.D., from the University of Erlangen-Nuremberg in Germany, and colleagues assessed whether bony lesions appearing on US imaging are cortical breaks that can be detected on micro-CT. A total of 14 patients with rheumatoid arthritis, eight patients with psoriatic arthritis, and six healthy controls were evaluated at the radial, palmar, and dorsal regions of the second metacarpophalangeal (MCP) joint, and the palmar and dorsal regions of the third and fourth MCP joints for bone erosions. Patients underwent US and micro-CT scanning. Bone erosion prevalence and severity by both methods were recorded and compared.

The investigators found that there was good correlation between erosion severity by both methods. False-negative results (US-negative, micro-CT positive) were mainly due to small erosive lesions at the dorsal side of the MCP joints, and were seen in 9.9 percent of joint regions. False-positive results (US-positive, micro-CT negative) were more common (28.6 percent) and were mainly vascular bone channels at the palmar sides of MCP joints and pseudo-erosions created by osteophytes.

"Most bone erosions detected by US are indeed erosive lesions as indicated by the confirmatory micro-CT analysis. As the spatial resolution of US has improved, false-negative results are relatively rare. In contrast, however, some of the erosive lesions detected by US do not correspond to cortical bone breaks seen on micro-CT," the authors write.

Two of the study authors disclosed financial ties to the pharmaceutical industry.

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