Background/Purpose: Joint destruction is the primary lesion by bone and cartilage damage in RA. By X-ray examination, cartilage destruction is evaluated as a joint space narrowing, although it is not the direct evaluation of cartilage itself. The aim of the study was to clarify the relationship between the finger joint cartilage evaluated by ultrasound (US) imaging and clinical characteristics in RA.

Methods: We examined 29 RA patients in clinical remission (DAS28-CRP < 2.6). The cartilage layer of metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints for 2nd to 5th fingers was bilaterally visualized from a dorsal view, with joints in approximately 90 degrees flexion. Cartilage thickness (CT) was measured with integrated tools on static images, and thickness was compared with other clinical and laboratory parameters.

Results: CT in MCP joints ranged from 0.0 to 0.8 mm (average 0.4 mm), and CT in PIP ranged from 0.0 to 0.5mm (average 0.2mm), respectively. The sum of total CT from 8 fingers ranged from 2.7 to 6.8 mm (average 4.8 mm). CT measured by ultrasound was not correlated with age, DAS28-CRP, functional disability score, positivity of rheumatoid factor and anti-CCP-antibody. However, there was significant relationship between CT and disease duration (r=-0.438, p=0.017). Moreover, CT was reduced in RA patients with elevated serum matrix metalloproteinase-3 (MMP-3) values compared with those with normal MMP-3 values (4.2 versus 5.0, p=0,046).

Conclusion: The US method of direct visualization and quantification of cartilage in MCP and PIP joints can be valid and useful in RA, and our results supported the importance of MMP-3 in the pathophysiology of cartilage destruction.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/relationship-between-finger-joint-cartilage-evaluated-by-ultrasound-and-clinical-characteristics-in-rheumatoid-arthritis-ra/