Document Detail


A diagnostic algorithm for persistence of very early inflammatory arthritis: the utility of power Doppler ultrasound when added to conventional assessment tools.
MedLine Citation:
PMID:  19359260     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this study was to assess the value of power Doppler ultrasound (PDUS) in combination with routine management in a cohort of patients with very early inflammatory arthritis (IA).
METHODS: 50 patients with < or =12 weeks of inflammatory symptoms with or without signs had clinical, laboratory and imaging assessments. Diagnosis was recorded at 12 months. Assuming a 15% pre-test probability of IA, post-test probabilities for various assessments were calculated and used to develop a diagnostic algorithm.
RESULTS: All patients positive for rheumatoid factor (RF) and/or cyclic citrullinated peptide (CCP) developed persistent IA, so the added value of PDUS was assessed in the seronegative (RF and CCP negative) group. The probability of IA in a seronegative patient was 6%. The addition of clinical and radiographic features raised the probability of IA to 30% and, with certain ultrasound features, this rose to 94%.
CONCLUSIONS: In seronegative patients with early IA, combining PDUS with routine assessment can have a major impact on the certainty of diagnosis.
Authors:
J E Freeston; R J Wakefield; P G Conaghan; E M A Hensor; S P Stewart; P Emery
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-04-08
Journal Detail:
Title:  Annals of the rheumatic diseases     Volume:  69     ISSN:  1468-2060     ISO Abbreviation:  Ann. Rheum. Dis.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-28     Completed Date:  2010-02-19     Revised Date:  2011-08-28    
Medline Journal Info:
Nlm Unique ID:  0372355     Medline TA:  Ann Rheum Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  417-9     Citation Subset:  IM    
Affiliation:
University of Leeds, Chapel Allerton Hospital, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Algorithms*
Arthritis, Rheumatoid / diagnosis,  ultrasonography*
Autoantibodies / blood
Biological Markers / blood
Decision Trees
Early Diagnosis
Female
Hand Joints / ultrasonography
Humans
Male
Middle Aged
Peptides, Cyclic / immunology
Prognosis
Rheumatoid Factor / blood
Sensitivity and Specificity
Ultrasonography, Doppler / methods
Young Adult
Chemical
Reg. No./Substance:
0/Autoantibodies; 0/Biological Markers; 0/Peptides, Cyclic; 0/cyclic citrullinated peptide; 9009-79-4/Rheumatoid Factor
Comments/Corrections
Erratum In:
Ann Rheum Dis. 2011 Aug;70(8):1519

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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