Background/Purpose: Synovial vascularity as measured by power Doppler (PD) of MSKUS is correlated to rheumatoid arthritis disease activity, and PD signal reveals the prevalence of subclinical synovitis overlooked on physical examination. It is frequently difficult to distinguish bone erosion from normal concave surface of the bone. It is necessary for us to know these normal structures well in evaluating disease activity by using MSKUS. Here we examine the age-specific differences of normal feeding vessels and bone surface irregularity between in wrist joints.To elucidate the differences of distribution of feeding vessels and bone surface irregularityin wrist jointsboth young and older adults of healthy volunteers.

Methods: The dorsal side of wrist jointswas scanned with 2D-probe in healthy volunteers(young<50 y.o, elder≧50 y.o). The distribution of feeding vesselsin the capsule and the extensor(E.) tendon sheath(TS), and the evaluation of bone surface irregularityat lunate(Lu) were examined. The comparative review between young and elderly adults was validated.

Results: The distributionof feeding vesselsin younger healthy volunteers (n=30:mean age 32.2±8.0) vs elderly healthy volunteers (n=21:mean age 66.0±7.2) were near-Trapezoid (Rt100.0%vs100.0％,Lt100.0%vs100.0％:p=1.00),E.digitorum TS(Rt86.7%vs81.0%:p=0.59,Lt66.7%vs76.2%:p=0.47),E.digiti minimi TS(Rt30.0%vs52.4%:p=0.11,Lt30.0%vs66.7%:p=0.0089),near-Capitate (Rt23.3%vs42.9%:p=0.14,Lt30.0%vs47.6%:p=0.21),near-TFCC(Rt16.7%vs19.0%:p=0.83,Lt30.0%vs38.1%:p=0.56),distal radial side of radiocarpal joint(Rt20.0%vs42.9%:p=0.08、Lt23.3%vs28.6%:p=0.68), distal end of Ulna(Rt10.0%vs42.9%:p=0.006.Lt16.7%vs28.6%:p=0.31). feeding vesselsfrom vascular channels were depicted at Lu(Rt53.3%vs52.4%:p=0.95,Lt46.7vs66.7%:p=0.16), Radius(Rt20.0%vs33.3%:p=0.29,Lt16.7%vs23.8%:p=0.54),Triquetrum (Rt10.0%vs42.9%:p=0.0057,Lt16.7%vs33.3%:p=0.17) and Capitate(Rt6.7%vs33.3%:p=0.013,Lt10%vs33.3%:p=0.0395). The bone surface irregularity as a transverse diameter (Mean±S.D.) at Lu of dominant hand in both groups were 1.26±0.33vs1.14±0.2mm:p=0.21, respectively.

Conclusion: The frequency of feeding vessel’s distributions in elderly adults were significantly higher at E.digiti minimi TS, distal end of Ulna and Triquetrum/ Capitate vascular channels compared to those of younger adults. It is suggested that these differences are crucial to evaluate the age-specific synovitis by ultrasound.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-characteristics-of-the-distribution-of-normal-feeding-vessels-between-young-and-elderly-adults-in-wrist-joints-of-healthy-volunteers-depicted-by-ultrasound-mskus/