This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Functional losses in rheumatoid arthritis can be prevented if patients are diagnosed early and if in these patients anatomical changes can be detected early. Conventional radiography is adequate for the study of established disease (joint space narrowing and erosions), but not for the study of early disease. Other imaging modalities, even if more expensive at the outset, can be justified in patients with early rheumatoid arthritis if their findings are going to lead to more aggressive therapies and potentially to better outcomes. High Resolution Ultrasound (HRUS) has proven to be superior to conventional radiography in detecting erosions in patients with early rheumatoid arthritis. We now propose that in addition to being superior in early detection of joint destruction (erosions, synovitis) (1) Serial HRUS can be used to more reliably detect anatomical changes not otherwise visualized with conventional radiography to evaluate disease progression in patients with early rheumatoid arthritis, and (2) to determine if any clinical or serologic parameters correlate with the ultrasound findings.
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