Joint and tendon involvement in systemic lupus erythematosus: an ultrasound study of hands and wrists in 108 patients

Abstract

The picture of musculoskeletal US in SLE depends on arthropathy subtype and disease activity. US examination could be a valid and reliable tool to monitor musculoskeletal features and therapeutic outcomes in SLE patients.

The role of imaging in the evaluation of joint involvement in 102 consecutive patients with systemic lupus erythematosus

“…Secondly, joint deformities are observed in up to 35% of patients and appear to be associated with difficulties in performing daily activities and may require surgery [10]. Finally, ultrasound studies have shown an unexpected high prevalence of synovitis, tenosynovitis and erosions also in SLE patients (Table 4) [13][14][15][16].…”

“…The wrist and 2nd-5th metacarpophalangeal joints (MCP) were the target joints and the study was performed with a low-field extremity dedicated 0.2 T instrument (C-scan, Esaote Biomedica, Genoa, Italy); coronal and axial T1-weighted gradient-echo images and coronal STIR images were acquired. The images acquired were scored according to the RAMRIS scoring system for RA by a trained radiologist unaware of the clinical picture and diagnosis [13,14]. Briefly, the erosions were scored from 0 to 10 according to the proportion (in increments of 10%) of bone involved.…”

“…Inflammatory alterations have been detected by US in the hand or wrist in up to 80% of unselected SLE patients and in more than 90% of patients with joint involvement [12][13][14][15][16]. Moreover, in the few small studies on SLE, MRI demonstrated good performances in the identification of structural damage and bone marrow edema (BME) which have been described in up to 94% and 14%, respectively, of patients with joint involvement [17][18][19].…”

Plasma IL-6 levels correlate with clinical and ultrasound measures of arthritis in patients with systemic lupus erythematosus

“…[7][8][9] The details of some of these studies have been reviewed elsewhere, 10 but all studies noted a higher than expected prevalence of synovitis, tenosynovitis and erosions than was estimated from clinical examination. The presence of erosions can obscure the boundary between SLE and rheumatoid disease.…”

Developing new evaluation methods in systemic lupus erythematosus

“…Moreover, the application of power Doppler allows to detect pathologically increased hematic perfusion, indicating an active synovitis. The studies conducted so far on SLE patients demonstrated the frequent detection of inflammatory signs in the radiocarpal joint (RC), followed by the metacarpophalangeal (MCP) and proximal-interphalangeal (PIP) joints [17][18][19]. Recently, we analyzed the involvement of metatarsophalangeal joints in a cohort of SLE patients, identifying a significantly higher frequency of inflammatory modifications compared with wrist, MCP and PIP joints [20].…”