In our practice we use ultrasound as the joint imaging technique of choice in patients with Rheumatoid arthritis (RA) and other forms of inflammatory arthritis. In patients with RA particularly at an early stage before bone damage has occurred x-rays will be normal. However, even at the earliest time shortly after the beginning of RA, Ultrasound can show swollen and inflamed synovial tissue and excessive joint fluid which are not visible on x-rays and frequently missed on physical exam. Also, very small erosions (bone damage) that are difficult to detect on x-ray are often very obvious when ultrasound is used.

As an additional benefit, ultrasound imaging avoids the radiation exposure inherent in x-ray procedures. This is important in everyone but particularly in younger patients since multiple imaging studies performed over time during treatment are necessary to help judge the effectiveness of therapy. Using ultrasound in this situation provides a much safer approach.

Painful hands, normal appearing on observation		Ultrasound examination of the hands
Ultrasound shows swelling		Ultrasound shows inflammation (red dots) near bone damage
Watch a movie to see what joint inflammation looks like in real time. Click for WMV (Windows) or Quicktime.