Diagnosis Arthritis Disease Using Ultrasound Scanner Machine

Khairul Fahzan Salleh

Politeknik Sultan Salahuddin Abdul Aziz Shah,
Persiaran Usahawan, Seksyen U1,
40150 Shah Alam, Selangor
skhairul@psa.edu.my
Abstract: - The Diagnosis of Arthritis Disease using ultrasound scanner machine is a combination between
the application of medical equipment ultrasound scanners and health problems namely arthritis. With
expansion in ultrasound technology, ultrasound machine is able to detect disease through crystallization
images produced from the joints tested. This clinical study will discussed a method to obtain a procedure
based on the corresponding image displayed with respondent from staff of Politeknik Sultan Salahuddin
Abdul Aziz Shah. Uric acid levels test will be conducted to ensure the validity of gout patients.
Keywords: Ultrasound, arthritis, gout, musculoskeletal

1.0

Introduction
The word of arthritis is derived from the joint arthro
and itis is inflammation. Gout is a one of arthritis disease
from rheumatism or arthritis disorder family. In the group
there are various arthritis, common arthritis are found is
osteoarthritis, rheumatoid arthritis, gout arthritis and
others. It can cause an attack of sudden pain, stiffness and
swelling in the joints, usually it attacks the joints in your
toes, ankles and knees. These attacks can happen over and
over again unless it is treated. At the same time it is able to
cause damage to the joints, tendons and other soft tissues.
Gout arthritis or more easily termed as gout can occur
caused by too much uric acid in the blood. When the level
of uric acid in the blood is too high, uric acid can
precipitate and form hard crystals in the joints. Factors that
influence to get Arthritis is excess weight, drinking
alcohol, or consumed too much meat and fish that are high
in chemicals called purines. The most common sign when
the patient is suffering from gout is swelling, redness, and
pain at finger thumb during the night. Acute attack can
occur in the leg, ankle, or knee. Period of the attack can
reach up to several weeks before the pain disappears.
Normal practice for determining a person suffering
from gout is to perform blood tests and a physical
examination. The medical officer will take a blood sample
and perform a blood test to measure the amount of uric
acid in blood. There are other methods in which patients
will be diagnosed through several radiography modalities
such as MRI, X ray and ultrasound to see the formation of
crystals in the joints. Ultrasound scan imaging is also
known as ultrasound, which involves exposing the body to
high-frequency to produce images of the body. Ultrasound
imaging does not use ionizing radiation such as x-rays.it is
able to show the structure and movement of the body's

internal organs as well as blood flowing through blood

vessels. Ultrasound imaging scan is based on the same
principle in the sonar used by bats, ships, fishermen and
meteorological services. When sound waves on an object,
it bounces back or is known as an echo.
By measuring the wavelength of this echo, it is able to
determine the distance of the object, the size, shape and
density of either a solid object, filled with fluid, or both. In
the operating principles of ultrasound, the transducer sends
and receives sound waves resonating waves. Wave
proceeds will be instantly measured and displayed by a
computer, and in turn will produce a picture in real-time.
2.0 Problem statement
Now days a group members of Polytechnic Sultan
Salahuddin Abdul Aziz Shah, have foot pain. This
condition is caused by a tired walk, shoes are not
appropriate or other health problems. They unexpectedly is
one of belongs to the group of patients suffering from gout.
For those who know they belong, even a blood test for uric
acid levels. But does that interfere with their joints cannot
be ascertained. Through use ultrasound scanner its can
confirm whether yes or not they belong to the class of
gout.
3.0
Objective of study
3.1.
To implement ultrasound scanner to identify gout
disease.
3.2.
To verify the difference between gout
crystallization images of patients and normal images.
4.0

Background of study

The expansion of development ultrasound scanner

technology,
caused
clinical
applications
for
musculoskeletal can be done. major contributing factor to
used ultrasound scanner rather than other mobility because
of cost effectiveness, fast access to the images, mobile, fast
scan time, and no radiation dose received by the patient.
Minimal interaction with patient can be promoting comfort
to the patient during the clinical procedure rather than
other modalities. Scanning technique is also easily
modified, as needed depending on the patient and
procedure of the study. Developments in the probe
transducer with colour Doppler capability and focal-ofview (FOV) better facilitate scanning and imaging process.
Tissue harmonic and 3-D image features in transducer is
able to prove and provide benefit to the diagnosis of
musculoskeletal problems. Imaging of arthritis using
ultrasound scanner is a new method in Malaysia. The
method of assessment using x rays machines have been
proven useful for practitioners who involved the course of
joint damage. An early stage of the joint damage is
development or erosion damage joints associated with
rheumatoid disease. This means that serious joint damage
must occur before it can be identified. Modern treatments
for rheumatoid arthritis are often directed at the beginner
stage.
There are efforts to detect the disease at an early stage
by using some radiographic imaging modalities including
magnetic resonance imaging (MRI) and ultrasound. MRI
scans have been found as a modality can sense sensitively
to changes in the joints, but the cost of a procedure is very
expensive and not widely available. Ultrasound is an
imaging method that attractive because of low cost, the
absence of harmful radiation, and produce fast imaging.
Recent advances in ultrasound imaging technology has
allowed the development of ultrasound scanning
equipment for imaging inflamed joints of patients with
arthritis. In a recent study published in Arthritis &
Rheumatism [1], ultrasound imaging has made comparison
with other imaging modalities. Results shown are the
effects of bone erosion in early rheumatoid arthritis can be
seen clearly. In this study, 100 patients with rheumatoid
arthritis undergoing ultrasound and x-ray imaging their
hands. While 20 control patients were selected for analysis
in ultrasound but does not use x-ray machines for
comparison. In rheumatoid arthritis patients 100 persons
in a group, 127 abnormalities were detected in 56 patients
by ultrasound, compared with 32 abnormalities in 17
patients detected by x-ray analysis. When patients with
early rheumatoid arthritis were analysed, 6.5 times more
abnormalities detected by ultrasound compared with the
films of x-ray. The erosion cannot be detected by x-ray but
not on ultrasound; correlation between erosion seen by x
-ray and those diagnosed by ultrasound was 86%.
From these results, the authors concluded that
ultrasound is a reliable technique with greater sensitivity
than x ray machine. Overall, these results indicate the

potential for an alternative method is fast, safe and

sensitive to traditional x-ray analysis of the joints of
rheumatoid arthritis patients. Thus from previous studies, it
proves to diagnose arthritis can also use an ultrasound
scanner to see a difference between the joint density and
the crystal
5.0

Methodology of study
This study will be done by comparison differences
image between two categories of respondents. The first
group of respondents who have a background of gout
and another which otherwise.
5.1 Sample
Samples are selected from Polytechnic Sultan
Salahuddin Abdul Aziz Shah members and
those who had received initial treatment at
clinic Polytechnic Sultan Salahuddin Abdul
Aziz Shah.
5.2 Instrument
This study will use ultrasound scanner
machines that have at Medical Imaging Lab,
Department of Electrical Engineering,
Politeknik Sultan Salahuddin Abdul Aziz
Shah. For the musculoskeletal system
examination, the patient is sitting or lying on
the examination bed or chair. Acoustic Waterbased gel used for this study is intended to
help the transducer make contact impedance
matching that decisions resulting lack of
noise elements. This ultrasound procedure
usually takes 15 to 30 minutes.
5.3 Limitation
This study only focused on member of
Polytechnic Sultan Salahuddin Abdul Aziz
Shah. A total of 20 samples will be involved.
15 patients from Gout potential patients and 5
are others. Sample patient are selected
through Polytechnic Sultan Salahuddin Abdul
Aziz Shah Clinic patient records.
5.4 Database
The resulting images are analysed manually
to see the difference density at the joint
which would reveal the presence of crystals
in the joints that suffer from gout.

5.5

Flow chart of study

Start
Identify samples
Run for uric acid test
yes
High level
uric acid

No

Scan for gout

Get the images

Match the
gout images

Analyze

Figure 1: Ultrasonography finding in longstanding

hyperuricaemia: outline of metatarsal head (arrows),
slightly irregular echogenic deposition (arrowheads) on
hyaline cartilage (anechoic line paralleling bony contour of
metatarsal head).

End

6.0
Expected outcome
The expected clinical result is image from the gout patient
able to match with images as Figure 1.

7.0 Conclusion
This study is a clinical study on the application of
ultrasound scanners. The study was a burst of studies with
respect to the ability of application-modality medical
imaging modality that can help to diagnose the disease.
With the advent of this study will help to diversify the
clinical procedure. Not only sampler baby scans for
pregnant content only. This study will also serve as the
starting point in the study next ultrasound applications
where the benefits of this ultrasound modality very much.

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