Document Detail


Ultrasound joint inflammation in rheumatoid arthritis in clinical remission: How many and which joints should be assessed?
MedLine Citation:
PMID:  23044729     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE.: To investigate the sensitivity for detecting subclinical synovitis of different reduced joint ultrasound (US) assessment models as compared with a comprehensive US assessment in RA patients in clinical remission. METHODS.: Sixty-seven RA patients (50 women, 17 men) in clinical remission judged by their consultant rheumatologist, treated with methotrexate were prospectively recruited. Patients were evaluated for disease activity according to the Disease Activity Score (DAS) 28 and the Simple Disease Activity Index (SDAI) by the same investigator. Each patient underwent a 44-joint B-mode and power Doppler (PD) assessment by a rheumatologist blinded to the clinical and laboratory data. B-mode synovial hypertrophy (SH) and synovial PD signal were scored 0-3 at each joint. Global indices for SH (SHI) and PD signal (PDI) were calculated for the 44 joint and different joint combination models for each patient. RESULTS.: SH was detected in 87.8% of patients with DAS28 < 2.6 and 81.8% of patients with SDAI < 3.3. Synovial PD signal was detected in 46.3% of patients with DAS28 < 2.6 and 36.4% of patients with SDAI < 3.3. Wrist, 2(nd) -5(th) metacarpophalangeal (MCP), ankle, and 2(nd) -5(th) metatarsophalangeal (MTP) joint and 12-joint US assessments showed the highest correlations with the comprehensive US assessment. The wrist-MCP-ankle-MTP US assessment showed the highest sensitivity for detecting SH and synovial PD signal in patients in remission according to DAS28 and SDAI as compared to the comprehensive US assessment. CONCLUSION.: US assessment of wrist-MCP-ankle-MTP joints can be highly sensitive for detecting residual B-mode and Doppler inflammation in RA patients. © 2012 by the American College of Rheumatology.
Authors:
Esperanza Naredo; Lara Valor; Inmaculada De la Torre; Julia Martínez-Barrio; Michelle Hinojosa; Francisco Aramburu; Juan Gabriel Ovalles-Bonilla; Diana Hernández; María Montoro; Carlos Manuel González; Javier López-Longo; Indalecio Monteagudo; Luis Carreño
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-8
Journal Detail:
Title:  Arthritis care & research     Volume:  -     ISSN:  2151-4658     ISO Abbreviation:  Arthritis Care Res (Hoboken)     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-9     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.
Affiliation:
Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Faculty of Medicine, Complutense University. Madrid, Spain. enaredo@ser.es.
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