The Clinical Application of Musculoskeletal Ultrasound in Diagnosing Palindromic Rheumatism-related Joint Lesions

Objective To explore the clinical application of musculoskeletal ultrasound in the diagnosis of joint lesions in palindromic rheumatism (PR). Methods Thirty-two PR patients (PR group) treated at the Department of Rheumatology, Ningbo No. 6 Hospital between January 2020 and January 2025 were selected as the study subjects. In parallel, 32 RA patients (RA group) admitted during the same period were included as controls. All patients subsequently underwent musculoskeletal ultrasound examination. A semi-quantitative grading method was employed to score synovial hyperplasia, synovial blood flow signal, bone erosion, and tenosynovitis. The incidence of ultrasound features and semi-quantitative scores was then compared between the two groups. Results Hand joint involvement was higher in the PR group than in the RA group, whereas knee joint involvement was higher in the RA group than in the PR group, with statistically significant differences ( p < 0.05). There were no statistically significant differences in the distribution of involvement for wrist, elbow, and foot/ankle joints between the two groups. The detection rates of tenosynovitis and periarticular subcutaneous soft tissue inflammation were higher in the PR group than in the RA group, with statistically significant differences ( p < 0.05). Furthermore, the detection rates of synovial thickening, synovial blood flow signal, and bone erosion were lower in the PR group than in the RA group, with statistically significant differences ( P < 0.05). The detection rate of joint effusion showed no statistically significant difference between the two groups ( P > 0.05). However, the total semi-quantitative ultrasound score, along with the scores for synovial hyperplasia, synovial blood flow signal, joint effusion, and bone erosion, were all lower than those in the RA group, with statistically significant differences ( P < 0.05). In contrast, the tenosynovitis score was higher in the PR group than in the RA group, with a statistically significant difference ( P < 0.05). Conclusion Arthritis in PR patients primarily affects the small joints of the hands, with musculoskeletal ultrasound revealing characteristic features. The semi-quantitative musculoskeletal ultrasound method can effectively assess arthritis in PR patients and shows promise as a diagnostic tool for this patient population.