Joint Ultrasonography in Rheumatoid Arthritis: Pathogenetic Rationale, Possible Use in Diagnosis, Therapy Efficiency Evaluation, and Outcome Prediction

Alekseeva, O.

doi:10.14412/1995-4484-2018-82-92

Cited by 5 publications

(1 citation statement)

References 62 publications

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“…Почти у половины пациентов, находя-щихся в клинической ремиссии, при УЗИ суставов выяв-ляются синовиальная гипертрофия и другие признаки си-новита [56,57]. В серии исследований продемонстрирова-ны преимущества УЗИ перед клиническими индексами в отношении прогнозирования развития обострения пос-ле снижения дозы ГИБП [58,59].…”

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Rheumatoid Arthritis: The Problems of Remission and Therapy Resistance

Nasonov¹,

Олюнин²,

Лила³

2018

rsp

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Ревматоидный артрит (РА) -иммуновоспалительное (аутоиммунное) ревматическое заболевание неизвест-ной этиологии, характеризующееся хроническим эрозивным артритом и системным поражением внутрен-них органов, приводящее к ранней инвалидности и сокращению продолжительности жизни пациентов. Не-смотря на достигнутые успехи в лечении РА, связанные с разработкой новых лекарственных препаратов и совершенствованием стратегии лечения, позволяющие добиться ремиссии у многих пациентов, остается много теоретических и клинических проблем, касающихся как определения понятия «ремиссия», ее харак-теристики и типов, так и подходов к оптимальной тактике «симптоматической» и «патогенетической» лекар-ственной терапии на разных стадиях болезни, применение которой позволит быстро индуцировать состоя-ние ремиссии и поддерживать ее в долгосрочной перспективе. Необходимы дальнейшие исследования, на-правленные на изучение природы гетерогенности патогенетических механизмов РА и подходов к ранней ди-агностике, совершенствование методов мониторинга активности заболевания, биомаркеров эффективности и резистентности к терапии и, наконец, разработку дифференцированной терапии, в том числе связанной с поиском новых «терапевтических» мишеней. Rheumatoid arthritis (RA) is an immunoinflammatory (autoimmune) rheumatic disease of unknown etiology, which is characterized by chronic erosive arthritis and systemic visceral organ damage that results in early disability and shorter patient survival. Despite RA treatment advances associated with the design of novel drugs and the improvement of treatment strategies to achieve remission in many patients, there are still many theoretical and clinical problems concerning both the definition of the concept of remission, its characteristics and types and approaches to the optimum policy of symptomatic and pathogenetic drug therapy at different stages of the disease, the use of which will be able to rapidly induce and maintain remission in the long-term. Further investigations are needed to study the nature of heterogeneity of pathogenetic mechanisms of RA and approaches to early diagnosis, to improve methods for monitoring disease activity and biomarkers for the efficiency of and resistance to therapy and, finally, to develop differentiation therapy, including those related to a search for new therapeutic targets.

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Rheumatoid Arthritis: The Problems of Remission and Therapy Resistance

Nasonov¹,

Олюнин²,

Лила³

2018

rsp

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Synovitis in osteoarthritis: the current state of the problem

Дыдыкина¹,

Арутюнова

Коваленко³

et al. 2021

Sovremennaâ revmatologiâ

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The article presents current data on synovitis (inflammation of the synovial membrane), which is often the only clinical manifestation of osteoarthritis (OA), and considered to be one of the risk factors for the OA development. Synovitis severity correlates with the severity of OA symptoms. The assessment of the prevalence of synovitis presents significant difficulties and depends on the nature and severity of the disease, the cohort in question, diagnostic method, and therapy. The classification based on etiological, clinical and histological characteristics of synovitis is presented. Examination of synovial tissue characteristics and its changes during inflammatory response can significantly expand the possibilities for therapy and prognosis. The use of symptomatic delayed-action drugs (SYSADOA) is considered as the basic treatment of OA. Chondroitin sulfate (Chondroquard®) is one of the well established drugs, it has symptom- and structural-modifying properties. The article presents the results of studies confirming its effectiveness in reducing the severity of knee synovitis.

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Capabilities of ultrasonography in the diagnosis of early rheumatoid arthritis and hand osteoarthritis

Krivotulova

Чернышева

Korochina

2021

Sovremennaâ revmatologiâ

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Objective: to compare results of ultrasound examination (US) of the wrist joints (WJ) and small joints of hands with the clinical signs in patients with early rheumatoid arthritis (eRA) and hand osteoarthriti (OAH).Patients and methods. The study included 42 patients with eRA (group 1) and 38 patients with OAH (group 2). The average age of patients with eRA was 48.60±14.86 years, the duration of clinical manifestations was 7.45±1.77 months, of patients with OAH – 54.97±12.45 years and 8.26±1.83 months, respectively. The ratio of men and women in both groups was approximately the same, the majority were women. All patients with eRA had clinical and instrumentally confirmed signs of OA: I, II, and III radiological stages of OA according to Kellgren–Lawrence were detected in 10 (23.80%), 23 (54.76%) and 9 (21.43%) patients respectively. In erosive OA II and III X-ray stage was diagnosed in 16 (42.10%) and 22 (57.90%) patients, respectively. All patients underwent ultrasound of the joints, as well as a general clinical examination, which included an assessment of the number of painful joints, the number of swollen joints, and a general assessment of pain intensity using a visual analogue scale (100 mm). RA activity was determined using the DAS28 index. We also studied laboratory parameters – the levels of CRP, rheumatoid factor and antibodies to cyclic citrullinated peptide in blood serum.Results and discussion. Comparison of the two groups of patients showed that ultrasound in B-mode and power Doppler mode with eRA and OAH showed more pronounced inflammatory and destructive changes in the wrist joints and small joints of the hands, with the exception of the distal interphalangeal joints (DIPJ). In addition, only in patients of the 1st group there was a close correlation between the enhancement of the Doppler signal and levels of inflammatory markers. Conclusion. eRA compared with OAH is characterized by more pronounced ultrasound signs of inflammatory and destructive changes in the wrist joins and small joints of the hands, with the exception of DIPJ.

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Joint Ultrasonography in Rheumatoid Arthritis: Pathogenetic Rationale, Possible Use in Diagnosis, Therapy Efficiency Evaluation, and Outcome Prediction

Cited by 5 publications

References 62 publications

Rheumatoid Arthritis: The Problems of Remission and Therapy Resistance

Rheumatoid Arthritis: The Problems of Remission and Therapy Resistance

Synovitis in osteoarthritis: the current state of the problem

Capabilities of ultrasonography in the diagnosis of early rheumatoid arthritis and hand osteoarthritis

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