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Sonographic erosions and power-Doppler signal predict radiographic damage in early arthritis: The ESPOIR ultrasonography longitudinal study.
MedLine Citation:
PMID:  23212992     Owner:  NLM     Status:  Publisher    
OBJECTIVE: This study aimed to assess the ability of ultrasonography (US) to predict radiographic damage in early arthritis. METHODS: ESPOIR is a multicentric cohort of early arthritis (i.e. ò 2 swollen joints between 6 weeks and 6 months). US synovitis in B mode and power Doppler (PD) and erosions were searched on MCP2 to 5 and MTP5 according to OMERACT definitions. Structural radiographic progression was assessed using the SHS erosion score at baseline, 1 and 2 years. Predictive factors of erosive arthritis at 2 years and rapid radiographic progression (RRP) at 1 year (defined by change of SHS erosion score ò 5) were searched. RESULTS: 127 patients were included: DAS28 5.1±1.3; 37.6% ACPA-positive; 27.6% with typical rheumatoid arthritis (RA) erosions on X-rays. At 2 years, 42 (39.2%) patients had typical RA erosions. US erosions predicted radiographic evidence of erosive arthritis (OR 1.44, 95% CI 1.04, 1.98). PD synovitis score was predictive of RRP at 1 year (OR 1.22, 95% CI 1.04, 1.42). US erosions and PD synovitis scores were associated with change of SHS erosion score on linear regression. On the 1184 analyzed joints, 105 (8.9%) had radiographic erosion at 1 year. At joint level, baseline US erosions were predictive of the presence of radiographic erosions at 1 year (p<0.001). The same trend was observed in the joints without radiographic erosions at baseline (p=0.052). CONCLUSION: US is useful to evaluate the potential severity of early arthritis: US erosions and PD positive synovitis have prognostic value to predict future radiographic damage. © 2012 by the American College of Rheumatology.
Thomas Funck-Brentano; Frédérique Gandjbakhch; Fabien Etchepare; Sandrine Jousse-Joulin; Anne Miquel; Catherine Cyteval; Cédric Lukas; Gabriel J Tobón; Alain Saraux; Patrick Boumier; Philippe Goupille; Pierre Bourgeois; Bruno Fautrel
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-4
Journal Detail:
Title:  Arthritis care & research     Volume:  -     ISSN:  2151-4658     ISO Abbreviation:  Arthritis Care Res (Hoboken)     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101518086     Medline TA:  Arthritis Care Res (Hoboken)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 by the American College of Rheumatology.
Department of Rheumatology, Pitié Salpétrière Teaching Hospital, Paris.
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