Hypervascular Synovitis and American College of Rheumatology Classification Criteria as Predictors of Radiographic Damage in Early Rheumatoid Arthritis

Pascual‐Ramos, Virginia; Contreras-Yáñez, Irazú; Cabiedes-Contreras, Javier; Rull-Gabayet, Marina; Villa, Antonio; Vázquez-Lamadrid, Jorge; Mendoza-Ruiz, Juan Jorge

doi:10.1097/ruq.0b013e3181981df0

Cited by 14 publications

(10 citation statements)

References 23 publications

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“…These data were in agreement with another study about a 2-year follow-up of RA patients, showing that the degree of synovial hyperaemia at baseline and the number of ACR criteria were the only predictive factors for the development of erosions [38]. More recently, a study applying MRI, PDUS, CT scan and radiography on 52 RA patients on therapy with adalimumab and MTX demonstrated the lack of clear evidence that subclinical synovitis is responsible for radiological progression; however, PDUS-detected synovitis as well as bone oedema at baseline have been found to be risk factors for erosions [39].…”

Section: Predictive Value Of Dopplersupporting

confidence: 92%

The role of Doppler ultrasound in rheumatic diseases

et al. 2012

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The use of Doppler techniques, including power, colour and spectral Doppler, has greatly increased in rheumatology in recent years. This is due to the ability of Doppler US (DUS) to detect pathological vascularization within joints and periarticular soft tissues, thereby demonstrating the presence of active inflammation, which has been reported to be correlated with the local neo-angiogenesis. In synovitis, DUS showed a high correlation with histological and MRI findings, thus it is considered a valid tool to detect pathological synovial vascularization. Moreover, it is more sensitive than clinical examination in detecting active joint inflammation and in the evaluation of response to treatment. In addition, DUS may be considered as a reference imaging modality in the assessment of enthesitis, MRI being not sensitive and histology not feasible. Moreover, it has been demonstrated to be able to detect changes in asymptomatic enthesis. In conclusion, DUS is a useful and sensitive tool in the evaluation and monitoring of active inflammation. Its widespread use in clinical rheumatological practice is recommended. The aim of this article is to review the current literature about the role of DUS in rheumatic diseases, analysing its validity, reliability and feasibility.

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Section: Predictive Value Of Dopplersupporting

confidence: 92%

The role of Doppler ultrasound in rheumatic diseases

et al. 2012

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“…Two LQ studies showed the same trend in the data, but statistical significance was not achieved (table 3). 18 25…”

Section: Resultsmentioning

confidence: 99%

What is the evidence for the presence of a therapeutic window of opportunity in rheumatoid arthritis? A systematic literature review

et al. 2013

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“…Third, synovial hypertrophy was present more frequently in patients with erosive abnormalities, confirming the well‐established concept that its presence is an independent risk factor for the development of erosive arthropathy (). Furthermore, the presence of hypervascular synovitis is a stronger predictor for radiologic damage and US erosions (). Finally, the high prevalence of osteophytes in patients with RA with respect to healthy controls (29% versus 12%) could be the expression of the simultaneous presence of inflammatory and degenerative changes, such as in data reported for distal interphalangeal joints in patients with RA ().…”

Section: Discussionmentioning

confidence: 99%

Sternoclavicular Joint Involvement in Rheumatoid Arthritis: Clinical and Ultrasound Findings of a Neglected Joint

Rodríguez-Henríquez

Solano

Peña

et al. 2013

Arthritis Care & Research

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Objective. To describe the prevalence of sternoclavicular (SC) joint involvement and the relationship between clinical and ultrasound (US) findings in patients with rheumatoid arthritis (RA). Methods. One hundred three consecutive patients with RA and 103 age-and sex-matched healthy individuals were enrolled. Clinical evaluation and blinded US examinations of the SC joint were performed bilaterally in both groups. The presence of gray-scale synovitis, osteophytes, erosions, and intraarticular power Doppler (PD) was recorded. Interobserver agreement was calculated. Results. A total of 412 SC joints were evaluated: 206 from patients with RA and 206 from healthy controls. In the RA group, 39 joints (19%) were found to be clinically involved (pain/swelling), in contrast to only 4 (1.9%) in the control group (P ‫؍‬ 0.0001). In the RA group, US abnormalities were recorded in 89 SC joints (43%) compared with 36 (17%) in the healthy control group (P ‫؍‬ 0.0001), comprising osteophytes in 59 (29%) versus 25 (12%; P ‫؍‬ 0.0001), synovitis in 31 (15%) versus 5 (2%; P ‫؍‬ 0.0001), erosions in 23 (11%) versus none (P ‫؍‬ 0.0001), and intraarticular PD in 5 (2%) versus none (P ‫؍‬ 0.03). Furthermore, a correlation between the presence of US synovitis (P < 0.001) and intraarticular PD (P < 0.0001) with a higher Disease Activity Score in 28 joints (DAS28) was found. Conclusion. In patients with RA, US detected a higher number of involved SC joints than with clinical assessment. Our results indicate that both gray-scale and PD US findings were more prevalent in patients with RA than in healthy controls. US synovitis and synovial hyperperfusion correlated with the DAS28, suggesting that SC joints actively participate in the systemic inflammatory process of RA.

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Hypervascular Synovitis and American College of Rheumatology Classification Criteria as Predictors of Radiographic Damage in Early Rheumatoid Arthritis

Abstract: Serial Power Doppler ultrasonography-assessed synovitis was greater in patients who developed erosions than in those who did not. More power Doppler positive (hypervascular) synovitis and more ACR classification criteria, both at baseline, were the only predictors of erosions.

Cited by 14 publications

References 23 publications

The role of Doppler ultrasound in rheumatic diseases

The role of Doppler ultrasound in rheumatic diseases

What is the evidence for the presence of a therapeutic window of opportunity in rheumatoid arthritis? A systematic literature review

Sternoclavicular Joint Involvement in Rheumatoid Arthritis: Clinical and Ultrasound Findings of a Neglected Joint

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