Detecting arthritis with light

Joint inflammation (arthritis) is a common problem in medical practice and can be due to a variety of causes. Many types of inflammatory disorders affecting the joints belong to the diverse group of rheumatic diseases. The most common ones are rheumatoid arthritis and osteoarthritis which frequently affect the joints of the hands. These joint diseases are chronic in nature and cannot be cured yet.

However, an early diagnosis and thus early medical treatment tremendously improves long-term outcome. That is why experts working on the EC-funded project IACOBUS led by the Fraunhofer Institute for Biomedical Engineering IBMT are developing a finger scanner which in the future will allow arthritis of the hands to be diagnosed at a very early stage. The team will be presenting a prototype of the new technology at the MEDICA trade fair in Düsseldorf from November 16 – 19 (Hall 10, Booth G05).

Human joints are incredibly high-tech. Layers of smooth cartilage facilitate swift motion of the bones without friction and the inner lining of the joint capsule, the so-called synovial membrane, shrouds the joint in a casing that constantly produces its own lubricant. For individuals suffering from chronic arthritis, however, this process is severely disturbed by an inflammation of the synovial membrane – which is most severe and destructive in cases of rheumatoid arthritis. Over time, inflammation of the synovium results in damage to the cartilage and even the bones of the joints thus causing severe pain and stiffening of the joints.

Chronic arthritis such as rheumatoid arthritis has no cure as yet, but when caught at an early stage it can be held in check successfully using medication. However, early detection of arthritis requires suitable imaging techniques. Conventional X-ray imaging will only detect typical features of arthritis at a fairly advanced stage. By contrast, use of Doppler ultrasound is more likely to detect arthritis at an earlier stage by visualizing changes in local blood flow. Increased blood flow in the inflamed and thickened synovial membrane is a typical sign of the condition, caused not only by widening of existing blood vessels but also by formation of new blood vessels as a result of the inflammatory process. However, since formation of blood vessels starts off very small with a correspondingly low blood flow, its detection by Doppler ultrasound at an early stage still remains challenging. Magnetic resonance imaging (MRI) can detect arthritic changes of cartilage and bone earlier than X-ray but is significantly more expensive than X-ray and Doppler ultrasound.

Scanner searches joints for sites of inflammation

To improve the early detection of different types of arthritis, a European consortium composed of several research institutions and companies led by the Fraunhofer Institute for Biomedical Engineering IBMT in Saarland, Germany is currently developing an alternative diagnostic technique combining ultrasound technology with novel detection methods. Specifically, this involves the use of a 3-D finger scanner that searches joints for sites of inflammation as well as other pathological changes. “One of the advantages of this method is that it enables us to detect the condition while it is still in its early stages, since many forms of arthritis affect the fingers first”, says Dr. Marc Fournelle, IACOBUS project manager at Fraunhofer IBMT.

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