OBJECTIVE: The study was undertaken to assess the diagnostic value of High Resolution Ultrasound with Colour Doppler in the evaluation of inflammatory  features of inflammatory arthropathywith MRI as reference method.

METHODS:  It was a prospective study conducted on 40 diagnosed patients  of inflammatory arthritis;30 RA , 7 gout, 1 SLE and 2 spondyloarthropathy patients. 40 joints were examined  for various inflammatory features of inflammatory arthropathy with USG and ColourDoppler and the findings were compared with those of contrast enhanced MRI.

RESULTS: With MRI as reference method, grey scale USG showed  sensitivity, specificity and accuracy of 94.1%, 16.6% and 82.5% respectively with poor agreement with MRI( kappa=0.13) for synovitis. On addition of Colour Doppler, the corresponding values were 79%, 83.3% and 77.5% respectively with moderate agreement with MRI. For detection of tenosynovitis, HRUS with Colour Doppler showed sensitivity, specificity and accuracy of 71.4%, 89.4% and 80.0% respectively with moderate level of agreement with MRI ( kappa=0.60).  A sensitivity, specificity and accuracy of 72.7%, 100.0% and 85.0% respectively were noted for detection of joint effusion with good agreement with MRI (kappa=0.70).

CONCLUSION: Although MRI is considered a reference imaging method for inflammatory arthritis, HRUS with Colour Doppler also shows good results for detection of inflammatory features of inflammatory arthropathy and could be a reasonably efficacious alternative to MRI.