427has the ability to detect early synovial hypertrophy and effusion as well as active
infl ammatory arthritic status [ 13 , 56 – 59 ]. Similarly, it is relevant in predicting the
course of the disease as well as the radiographic progression [ 23 ]. This agreement
between US and functional disability measurements was supported by the fi ndings
of the study carried out by Gartner et al. [ 60 ] on 90 patients known to have infl am-
matory arthritis for a mean of 9.4 years (SD 8.9). Results revealed that RA patients
having a high-grade PD signal (PD grade 3) showed a doubling of the Health
Assessment Questionnaire-Disability Index (HAQ-DI) values (mean ± SD HAQ-DI
score 0.45 ± 0.62) compared to patients whose PD grades were lower (PD grade ≤ 2)
where HAQ-DI score (mean ± SD) was 0.24 ± 0.41 and in patient with any PD grade,
the HAQ DI score was 0.20 ± 0.35. These fi ndings are also in agreement with those
reported in another recent study [ 50 ], which included 480 patients suffering from
early infl ammatory arthritis (mean disease duration was 6.3 ± 2.1 months). Results
revealed that changes in functional disability scores were signifi cantly correlated
with changes in power Doppler scores. Similarly, fl are up of the disease was associ-
ated with poor baseline functional disability measures as well as US-Grayscale
score/PD score ≥ 2.
Fig. 18.2 Longitudinal dorsal image of a PIP joint with ( a ) GS and ( b ) PD synovitis
18 PROMs and Musculoskeletal Ultrasonography