Hand ultrasound: Comparative study between “no rhupus” lupus erythematosus and rheumatoid arthritis

Buosi, Ana Letícia Pirozzi; Natour, Jamil; Machado, Flávia Soares; Takahashi, R.D.; Furtado, Rita Nely Vilar

doi:10.3109/14397595.2013.857583

Cited by 16 publications

(23 citation statements)

References 22 publications

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“…To date, few studies have been carried out on this topic with controversial results. The prevalence of synovitis and tenosynovitis, as well as pathological PD signal and bone erosions, was found to vary considerably among the different papers, 6,7,10,24–31 limiting the reliability of this imaging tool in SLE patients.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 Another interesting topic was the unexpected erosive burden found in SLE patients, as well as in those SLE phenotypes traditionally considered not to be erosive, such as JA. 8–10 Along with data emerging from magnetic resonance imaging (MRI) studies, 11 this latter feature led to the reconsideration of the traditional concepts of SLE arthritis classification, pathogenesis, and natural history. 12…”

Section: Introductionmentioning

confidence: 99%

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Systemic lupus erythematosus arthropathy: the sonographic perspective

Matteo

Angelis

Cipolletta

et al. 2017

Lupus

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Background Despite being promising, the use of ultrasound (US) in the assessment of musculoskeletal manifestations of systemic lupus erythematosus (SLE) is still limited. Literature on this topic is scarce and the spectrum and clinical relevance of US abnormalities has not yet been outlined. With this paper, we aim to explore the panel of joint and tendon US findings in a group of SLE patients. Methods Twenty-five consecutive SLE patients, with current or medical history of musculoskeletal symptoms, were studied. All patients underwent routine clinical examination and US evaluation. The US examination targeted sites clinically involved in the physical examination and/or indicated as painful in the patient's medical history. Results One or more US changes were found in all the patients. US abnormalities were detected in 85 out of the 243 scanned joints (35%), in 70 out of the 215 scanned tendons (32.6%) and in 10 out of the 41 scanned entheses (24.4%). Synovial effusion, synovial hypertrophy, "mixed" synovitis (coexistence of synovial effusion and synovial hypertrophy), joint dislocation, bone erosion, and cartilage damage were found in 9.5%, 11.5%, 14%, 3.7%, 2.1%, and 4.5% of the scanned joints, respectively. Tenosynovitis, tendon dislocation, tendon tear, tendon thinning, and tendinitis/peritendinitis were detected in 17.7%, 8.4%, 0.9%, 4.2%, and 4.7% of the scanned tendons, respectively. Power Doppler signal, hypoechogenicity, thickening, enthesophytes, calcifications, and bone erosions were detected at the entheseal level in 12.2%, 9.8%, 12.2%, 7.3%, 7.3%, and in 0% of the scanned entheses, respectively. Conclusions This study revealed an unexpectedly wide heterogeneity of US pathologic findings in the joints and tendons of patients with SLE. A broad spectrum of US changes also involving anatomic structures not considered in previous investigations, including entheses and tendons with no synovial sheath, was detected. These preliminary results suggest that US is able to identify several US "patterns" whose clinical, prognostic, and pathogenetic significance is still to be defined.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Systemic lupus erythematosus arthropathy: the sonographic perspective

Matteo

Angelis

Cipolletta

et al. 2017

Lupus

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“…In other studies US showed the presence of inflammatory signs both in asymptomatic patients and those with arthralgia without objective clinical signs of inflammation, the exact prevalence of which cannot be extrapolated as these studies did not clearly separate the US findings detected in these two categories of patients. [25][26][27][28][29][30][31][32][33][34]…”

Section: Subclinical Inflammation At Joint and Tendon Levelmentioning

confidence: 99%

“…A recent important insight into musculoskeletal involvement in patients with SLE is the detection of an unexpectedly high, albeit variable among the different studies, prevalence of erosive damage. 19,20,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] In US studies that clearly separated the different SLE arthropathy subsets, bone erosions were also found in a considerable number of patients with SLE arthropathy subsets traditionally considered non-erosive, such as Jaccoud's arthropathy and NDNE arthritis.…”

Section: Structural Damage In Sle Arthritismentioning

confidence: 99%

Ultrasound in the assessment of musculoskeletal involvement in systemic lupus erythematosus: state of the art and perspectives

Matteo

Isidori

Corradini

et al. 2019

Lupus

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Musculoskeletal manifestations are extremely common in patients with systemic lupus erythematosus. Transient and migratory arthralgia is frequently reported even without clinical signs of joint or tendon inflammation. In less than 15% of patients, joints may be more severely affected by deforming (Jaccoud's arthropathy) and/or erosive arthropathy (Rhupus syndrome). In recent years, ultrasound has emerged as a promising imaging technique for the assessment of musculoskeletal involvement in systemic lupus erythematosus, having demonstrated the ability to detect inflammation and structural damage both at articular and periarticular level. Recent ultrasound studies have also revealed new insights into musculoskeletal involvement in patients with systemic lupus erythematosus, some of them questioning the traditional concepts of systemic lupus erythematosus arthropathy, with potential clinical, prognostic and therapeutic implications. In daily clinical practice, the use of ultrasound in the assessment of joint and tendon involvement in patients with systemic lupus erythematosus is still limited. Several methodological issues encountered in ultrasound studies evaluating musculoskeletal involvement in systemic lupus erythematosus patients need to be addressed in order to improve both the reliability and clinical usefulness of ultrasound findings. This paper reviews ultrasound studies assessing musculoskeletal involvement in patients with systemic lupus erythematosus, highlighting certainty, limits, potential applications and future perspectives of ultrasound use in systemic lupus erythematosus patients.

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“…Most clinical reports focused on describing the disease characteristics of rhupus [ 3 , 4 ] and its pathogenesis [ 7 ]. There were also several studies on joint symptoms and bone destruction in SLE patients [ 8 – 10 ]. However, the inflammation and bone destruction of the joints of rhupus patients were rarely described.…”

Section: Introductionmentioning

confidence: 99%

Need for Greater Attention to Joint Damage in Rhupus Patients: Results from an Ultrasound Study

et al. 2020

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Background The aim of this study was to evaluate the prevalence of inflammation and bone destruction of hand joints in rhupus patients through ultrasound examination. Material/Methods Ten rhupus patients and 33 systemic lupus erythematosus (SLE) patients with hand arthropathy were recruited in this single-center study, and the clinical features and ultrasound manifestations of these patients were analyzed. Results We discovered that rhupus patients were older (47.31±4.35 years vs. 38.58±2.50 years, P =0.040), had longer duration of disease (median 72 months vs. median 12 months, P =0.040), had a higher positive rate (70% vs. 10.71%, P <0.001), and had higher titers of anti-CCP antibody (42.633±14.520 vs. 2.121±0.970, P <0.001) than SLE patients with arthropathy. More importantly, the prevalence rates of synovial hyperplasia (90% vs. 42.42%, P =0.008), synovitis (90% vs. 18.18%, P <0.001), synovial hyperplasia (70% vs. 10.71%, P <0.001), and bone destruction (70% vs. 6.06%, P <0.001) were higher in rhupus patients than in SLE patients with arthropathy. Conclusions Rhupus patients are more prone to develop synovitis, synovial hyperplasia, and bone destruction. Therefore, more attention should be paid to protection of the joints in rhupus patients.

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Hand ultrasound: Comparative study between “no rhupus” lupus erythematosus and rheumatoid arthritis

Abstract: US of "no rhupus" SLE and RA patients is different, especially in wrists. In SLE patients the clinical variable most associated with US findings was "puffy hands."

Cited by 16 publications

References 22 publications

Systemic lupus erythematosus arthropathy: the sonographic perspective

Systemic lupus erythematosus arthropathy: the sonographic perspective

Ultrasound in the assessment of musculoskeletal involvement in systemic lupus erythematosus: state of the art and perspectives

Need for Greater Attention to Joint Damage in Rhupus Patients: Results from an Ultrasound Study

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