Objective. To confirm by correlation of the ultrasound examination and magnetic resonance the validity of these imaging algorithms in the detection of early morphological changes of the hand in incipient rheumatoid arthritis. Methods. The authors examined 80 patients with the clinical diagnosis of early rheumatoid arthritis. In all probands X-ray pictures of the hands were made and the stage was assessed according to Steinbrocker. The patients were at the same time examined by ultrasound and magnetic resonance and the results of the evaluation were entered in a uniform examination protocol. By means of both methods morphological changes of all joints, flexors and extensors were evaluated. Results. A total of 1760 joints were examined. Examination b y ultrasound and magnetic resonance were in detection of inflammatory changes in early rheumatoid arthritis significantly more sensitive than conventional skiagraphy. Both imaging techniques are approxi- mately equally sensitive in detection of tenosynovitis (ultrasound examinations 50.1 % detection, magnetic resonance 49.9 %). In evaluation of synovialitis magnetic resonance is more sensitive (58 %), while exudates are better evaluated by ultrasound examination (58.70 %). Synovialitis was proved in 66 patients of 80. By magnetic resonance it was proved in 456 joints, by ultrasound only in 330. An exudate in the joint was detected in 51 patients of 80; sonography 186x and 124x by magnetic resonance. Tenosynovitis was found in 44 patients of 80, the results were alm ost identical (ultrasound 174x, magnetic resonance 173x). On correlation of both methods on a signal joint (metacarpophalangeal articulation of the second finger of the right hand) agreement of the two techniques was 70 %. Statistical evaluation was made by the t-test, the level of significance ultra - sound/magnetic resonance in synovialitis was p < 0.001, in exudate p < 0.005, in tenosynovitis p < 0.001. Correlation coefficient 0.857. Conclusion. The results confirm the validity o f sonography and magnetic resonance in the detection of morphological changes of the hands in patients with the diagnosis of incipient rheumatoid arthritis. Both techniques can become part of the routine examination algorithm in the evaluation of early stages of this disease.

        Key words: sonography, magnetic resonance, early rheumatoid arthritis