The purpose of the present study was to evaluate by ultrasound methods and carry out a one-year follow-up study of synovial proliferation in the knee joint of patients with rheumatoid arthritis prior to and after arthroscopy and arthroscopic (AS) synovectomy.
Material and methods: 24 patients with a proven rheumatoid arthritis and affected knee joints were recruited for the study. Arthroscopic synovectomy of one of the affected joints was performed in all of them. The synovitis was evaluated clinically and ultrasonographically in 24 knee joints prior to the AS synovectomy and 7 days, and 3, 6 and 12 months after it.
Results: Either synovial thickening or villonodular proliferation in the knee joints were the findings in the examined patients using arthrosonography. All patient showed improvement of the disease activity index after the arthroscopic synovectomy and weakening of the baseline ultrasound evidence for synovial thickening and villonodular proliferation (p < 0.001). During the 12-month follow up study two patients were found at ultrasonography to have (without any clinical evidence for that) recurrence of the synovial thickening three months after arthroscopy. Ten patients had synovial thickening or villonodular proliferation recurrence during the 12 months of follow up with clinical evidence of gonitis; one case showed ultrasonographic evidence of hydrops. There was a complete consistency between the ultrasound and arthroscopic protocols with respect to the presence of synovial proliferation and intra-articular effusion.
Conclusion: Arthosonography is an easy, safe, low-cost, non-invasive modality for diagnosis and follow-up of patients with rheumatoid arthritis prior to and after arthroscopic synovectomy and for assessment of the clinical prognosis in such patients.