Assessment of Joint inflammatory activity in rheumatoid arthritis: a comparative study between clinical evaluation and musculoskeletal ultrasound | ||||
| Sohag Medical Journal | ||||
| Article 60, Volume 21, Issue 3, October 2017, Page 507-215 PDF (82.11 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/smj.2017.47650 | ||||
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| Abstract | ||||
| Introduction: Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by the development of synovitis, which damages cartilage, bone, ligaments, and tendons. US is available, noninvasive, and relatively inexpensive bedside imaging method with high patient acceptability. This technique is more sensitive and reproducible than clinical evaluation in assessing joint inflammation. Power Doppler (PD) US detect flow from small vessels and low velocity flow at the microvascular level. PD US detects indirect signs of increased vascularization associated with soft tissue musculoskeletal inflammatory and infectious diseases and enteritis in spondyloarthropathies. Aim of the work: Evaluating the correlation between the hand-swollen joints at a certain time-point and the subsequent structural deterioration using ultrasound. Patients and Methods: longitudinal observational study included 30 Adult patients fulfilling 2010 Rheumatoid arthritis classification criteria: An American College of Rheumatology/European League Against Rheumatism criteria will be included in this study. Results: DAS, other paremeters of disease activity as ESR, CRP, swollen and tender joints is always positively and highly significantly correlated to disease severity both by total US gray scale count and total US PD score count at any time during follow up of our patients from start, after 6 months and after 12 Conclusion: The combination of grey scale US and PD could be used as a sensitive and reliable non-invasive and widely available method complementary to standard clinical assessment for evaluating rheumatoid synovial inflammation in daily management and clinical trials. | ||||
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1. Aletaha D, Smolen J, Ward MM. Measuring function in rheumatoid arthritis: Identifying reversible and irreversible components. Arthritis and rheumatism. 2006;54(9):2784-92.
2. Pap T, Distler O. Linking angiogenesis to bone destruction in arthritis. Arthritis and rheumatism. 2005;52(5):1346-8.
3. Naredo E, Bonilla G, Gamero F, Uson J, Carmona L, Laffon A. Assessment of inflammatory activity in rheumatoid arthritis: a comparative study of clinical evaluation with grey scale and power Doppler ultrasonography. Annals of the rheumatic diseases. 2005;64(3):375-81.
4. Karim Z, Wakefield RJ, Quinn M, Conaghan PG, Brown AK, Veale DJ, et al. Validation and reproducibility of ultrasonography in the detection of synovitis in the knee: a comparison with arthroscopy and clinical examination. Arthritis and rheumatism. 2004;50(2):387-94.
5. D'Agostino MA, Said-Nahal R, Hacquard-Bouder C, Brasseur JL, Dougados M, Breban M. Assessment of peripheral enthesitis in the spondylarthropathies by ultrasonography combined with power Doppler: a cross-sectional study. Arthritis and rheumatism. 2003;48(2):523-33.
6. Garrigues F, Jousse-Joulin S, Bouttier R, Nonent M, Bressollette L, Saraux A. Concordance between clinical and ultrasound findings in rheumatoid arthritis. Joint, bone, spine :revue du rhumatisme. 2013;80(6):597-603.
7. Dougados M, Jousse-Joulin S, Mistretta F, d'Agostino MA, Backhaus M, Bentin J, et al. Evaluation of several ultrasonography scoring systems for synovitis and comparison to clinical examination: results from a prospective multicentre study of rheumatoid arthritis. Annals of the rheumatic diseases. 2010;69(5):828-33.
8. Scire CA, Montecucco C, Codullo V, Epis O, Todoerti M, Caporali R. Ultrasonographic evaluation of joint involvement in early rheumatoid arthritis in clinical remission: power Doppler signal predicts short-term relapse. Rheumatology. 2009;48(9):1092-7.
9. Peluso G, Michelutti A, Bosello S, Gremese E, Tolusso B, Ferraccioli G. Clinical and ultrasonographic remission determines different chances of relapse in early and long standing rheumatoid arthritis. Annals of the rheumatic diseases. 2011;70(1):172-5.
10. Saleem B, Brown AK, Quinn M, Karim Z, Hensor EM, Conaghan P, et al. Can flare be predicted in DMARD treated RA patients in remission, and is it important? A cohort study. Annals of the rheumatic diseases. 2012;71(8):1316-21.
11. Abe A, Ishikawa H, Nakazono K, Murasawa A, Wakaki K. A comparison of the ultrasonography images of the joints of patients with rheumatoid arthritis and the corresponding synovial histological findings. Modern rheumatology. 2016;26(4):534-9.
12. Zufferey P, Moller B, Brulhart L, Tamborrini G, Scherer A, Finckh A, et al. Persistence of ultrasound synovitis in patients with rheumatoid arthritis fulfilling the DAS28 and/or the new ACR/EULAR RA remission definitions: results of an observational cohort study. Joint, bone, spine : revue du rhumatisme. 2014;81(5):426-32.
13. Ellegaard K, Torp-Pedersen S, Terslev L, Danneskiold-Samsoe B, Henriksen M, Bliddal H. Ultrasound colour Doppler measurements in a single joint as measure of disease activity in patients with rheumatoid arthritis--assessment of concurrent validity.Rheumatology.2009;48(3):254-7.
14. Karim Z, Wakefield RJ, Conaghan PG, Lawson CA, Goh E, Quinn MA, et al. The impact of ultrasonography on diagnosis and management of patients with musculoskeletal conditions. Arthritis and rheumatism. 2001;44(12):2932-3.
15. Wakefield RJ, Green MJ, Marzo-Ortega H, Conaghan PG, Gibbon WW, McGonagle D, et al. Should oligoarthritis be reclassified? Ultrasound reveals a high prevalence of subclinical disease. Annals of the rheumatic diseases. 2004;63(4):382-5. 16. Qvistgaard E, Rogind H, Torp-Pedersen S, Terslev L, Danneskiold-Samsoe B, Bliddal H. Quantitative ultrasonography in rheumatoid arthritis: evaluation of inflammation by Doppler technique. Annals of the rheumatic diseases. 2001;60(7):690-3.
17. Luukkainen RK, Saltyshev M, Koski JM, Huhtala HS. Relationship between clinically detected joint swelling and effusion diagnosed by ultrasonographyin metatarsophalangeal and talocrural joints in patients with rheumatoid arthritis. Clinical and experimental rheumatology. 2003;21(5):632-4.
18. Hammer HB, Bolton-King P, Bakkeheim V, Berg TH, Sundt E, Kongtorp AK, et al. Examination of intra and interrater reliability with a new ultrasonographic reference atlas for scoring of synovitis in patients with rheumatoid arthritis. Annals of the rheumatic diseases. 2011;70(11):1995-8.
19. Ogishima H, Tsuboi H, Umeda N, Horikoshi M, Kondo Y, Sugihara M, et al. Analysis of subclinical synovitis detected by ultrasonography and low-field magnetic resonance imaging in patients with rheumatoid arthritis. Modern rheumatology. 2014;24(1):60-8.
20. Kawashiri SY, Suzuki T, Nakashima Y, Horai Y, Okada A, Iwamoto N, et al. Ultrasonographic examination of rheumatoid arthritis patients who are free of physical synovitis: power Doppler subclinical synovitis is associated with bone erosion. Rheumatology. 2014;53(3):562-9.
21. Szkudlarek M, Court-Payen M, Jacobsen S, Klarlund M, Thomsen HS, Ostergaard M. Interobserver agreement in ultrasonography of the finger and toe joints in rheumatoid arthritis. Arthritis and rheumatism. 2003;48(4):955-62. | ||||
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