الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Ultrasound imaging is currently a commonly acknowledged and widely used method in the diagnosis of rheumatic diseases. In the recent years, it has become an essential supplementation of physical examination in the rheumatologist practice. Modern equipment enables imaging of structures with the resolution up to 0.1 mm, which helps detect slight inflammatory foci and early joint damage. This examination is highly sensitive in detecting effusion and synovial hypertrophy. Additionally, Doppler modes (power Doppler (PD), and color Doppler (CD) help present evidence of enhanced vascularity in tissues affected by the inflammatory process. Moreover, ultrasound imaging is more sensitive in detecting rheumatoid erosions than conventional radiography. Therefore, the aim of the present study was to describe the prevalence of (temporomandibular joint) TMJ, and elbow joint involvement and to investigate the relationship between clinical and US findings in patients with RA, SLE and PsA.
This cross-sectional descriptive study was conducted at Rheumatology Department, Suez Canal University Hospital in Ismailia. Ninety patients who fulfill the revised classification criteria of the American College of Rheumatology for SLE, RA and psoriatic arthritis were recruited from the Rheumatology Department, Suez Canal University hospital.
This study involved 30 patients with SLE, 30 patients with RA and 30 patients with PsA. RA and PsA had higher mean age with predominance of female gender in all the study groups. RA patients had longer disease duration than SLE and PsA patients (p<0.001).
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All patients with RA had polyarticular joint involvement, whereas 50% and 46.7% of PsA and SLE patients had pauciarticular involvement, respectively (p<0.001). No one in SLE patients had joint deformity, meanwhile 73.3% and 6.7% of RA and PsA had deformities, respectively (p<0.001). The mean levels of ESR and CRP were significantly higher in RA patients in comparison to SLE and PsA patients (p<0.001).
The frequency of high disease activity was significantly elevated among SLE patients (76.7%), followed by RA patients (60.0%) and PsA patients (40.0%) (p=0.015).
Musculoskeletal ultrasound was used to scan and evaluate 540 joints of temporomandibular (TMJ), elbow and enthesis of 30 SLE patients, 30 RA patients and 30 PsA patients. Two aspects of the TMJ were studied: the disc and condylar changes. The structural and morphological variations of the TMJ disc were assessed. Additionally, TMJ condylar erosions and morphological changes were observed. TMJ disc morphological changes and condylar erosions were significantly higher among RA patients (20.0% and 33.3%, respectively) than PsA patients (6.7% and 10.0%, respectively) and SLE patients (0.0% and 6.7%, respectively).
Elbow joints were examined regrading gray scale (GS) and power doppler (PD)