Power Doppler ultrasonography of symptomatic rheumatoid arthritis ankles revealed a positive association between tenosynovitis and rheumatoid factor

Suzuki, Takeshi; Tohda, Eiichi; Ishihara, Keiko

doi:10.3109/s10165-009-0150-8

Cited by 16 publications

(5 citation statements)

References 18 publications

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“…In terms of pathology prevalence, the TTJ was the most affected (39.8%), followed by the TNJ (37.2%), the STJ (27%), and the CCJ (9.2%). Our findings were similar to those of Alsuwaidi et al 12 and Enache et al, 13 but differed from Suzuki et al, 14 who found higher frequencies of TTJ synovitis (76%), STJ synovitis (71%), and TNJ synovitis (59%). The difference could be explained by their small sample size of only 17 RA patients.…”

Section: Discussionsupporting

confidence: 86%

“…Another significant finding in our study was the high prevalence of Achilles enthesitis (37.8%). Although it is commonly associated with spondyloarthropathy, some studies like those of Suzuki et al 14 or Genc et al, 16 have described it in about 40% of RA. Our results agree with them, and this should attract the attention to focus on Achilles tendon during follow up of RA.…”

Section: Discussionmentioning

confidence: 99%

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Ankle and foot pathologies in early rheumatoid arthritis, what can ultrasound tell us?

et al. 2022

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Background Rheumatoid arthritis (RA) is a systemic autoimmune polyarticular disease. Despite being commonly affected in RA, the ankle and foot do not receive much attention, particularly in early disease. The precise diagnosis of their involvement and its impact on health is a clinical challenge that requires accurate assessment. Aim To determine the role of ultrasound in evaluation of ankle and foot pathologies and assess its impact on functional activity in newly diagnosed RA patients. Methods The study was conducted on 152 RA patients and 52 healthy controls. Patients were subjected to history taking, clinical examination, and ultrasound scan. Impact on health was measured by health assessment questionnaire, as well as foot function index. Results In a cohort of patients with early RA with median duration of 1 month, tibialis posterior (TP) tenosynovitis (45.4%) was the most common pathology, followed by tibiotalar (TTJ) synovitis (39.8%), and peroneal tenosynovitis (39.1%). In terms of disease duration, TTJ (P = .001) foot pathologies were less common in early RA and tended to worsen over time, whereas TP (P = .048) and peroneal tenosynovitis (P = .011) were more common in early RA. In multivariate analysis TTJ, subtalar synovitis, forefoot pathologies, TP tenosynovitis, and Achilles enthesitis were found to be significant predictors of functional disability. The most important predictors of ankle pain were TTJ synovitis, TP tenosynovitis, peroneal tenosynovitis, and plantar fasciitis. Conclusion Ankle and foot involvement is a common issue of early RA, and it has a significant impact on quality of life. Ultrasound is a reliable tool for evaluating various abnormalities in this complex area, allowing for better management.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Ankle and foot pathologies in early rheumatoid arthritis, what can ultrasound tell us?

et al. 2022

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“…In 2009, Suzuki et al . found that 76%, 71% and 59% of their symptomatic RA patients had tibiotalar synovitis, subtalar synovitis and talonavicular synovitis, respectively.…”

Section: Discussionmentioning

confidence: 99%

Ankle pathologies in patients with inflammatory rheumatic diseases: a clinical and ultrasonographic study

Harman

Tekeoğlu

2017

Int J Rheum Dis

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“…If the aim of RA treatment is to preserve joint function, the screening of TP tenosynovitis should represent an important step in assessing walking and gait in RA patients. The association of TP tenosynovitis with higher RF titres (also noted by Suzuki et al [8]), but not with ACPA is puzzling. High RF titres are specific for RA and their presence is considered to be a prognostic factor since seropositivity is associated with disease progression [20] and mortality [21].…”

Section: Discussionmentioning

confidence: 87%

“…However, Gutierrez et al [7] agreed that the most common ultrasound anomaly was tenosynovitis, but they reported that the most frequent tendons involved were TP (31.9%), peroneus longus (PL; 26.9%) and peroneus brevis (PB; 23.6%), with no significant association of ankle ultrasound findings with DAS28. Investigating clinical associations of ankle tenosynovitis, Suzuki et al observed a positive association between ankle tenosynovitis and rheumatoid factor (RF) levels [8] and the fact that tenosynovitis was significantly more common in early RA ankles (disease duration under 6 months) [9]. Ankle tenosynovitis is responsible for secondary tendon dysfunction [10] and it is responsive to RA treatment [11].…”

Section: Introductionmentioning

confidence: 99%

Ankle ultrasound tenosynovitis is a significant predictor of DAS28 – defined rheumatoid arthritis activity

Enache¹,

Popescu²,

Codreanu³

et al. 2019

Ro J Rheumatol.

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Objective. The study aimed to observe the frequency of ultrasound-defined tenosynovitis in ankle tendon and to evaluate the relationship of ankle tenosynovitis with clinical examination and rheumatoid arthritis (RA) activity measures. Methods. RA patients were recruited in 2018 in the random order of presentation from the outpatient clinic. On the same day of inclusion, all patients underwent clinical examination, laboratory tests (inflammatory markers), ankle ultrasound and patient-reported outcomes. Results. the study included 183 patients with established RA, mostly women (86.3%), with mean age of 57.3 years. The most frequent tenosynovitis was observed in the tibialis posterior tendon (TP; 40.4%), followed by the peroneus longus (23.0%) and peroneus brevis (18.0%) tendons. Compared to patients without TP tenosynovitis, patients with TP tenosynovitis had significantly higher titres of rheumatoid factors (RF; median of 123 IU/mL compared to 64 IU/mL; p = 0.023). Clinically tender (55.2%) and swollen (30.6%) ankles were 4.2 and respectively 11.6 times more likely to reveal tenosynovitis on ultrasound. The presence of ankle tenosynovitis was associated with higher disease activity measures. DAS28 increased proportionally and significantly with the number of ankles with tenosynovitis, the grade of ankle tenosynovitis and power Doppler activity. The absence of ankle tenosynovitis independently and significantly decreased DAS28 with 1.2 points (p < 0.001). Conclusions. the most frequent ankle tenosynovitis observed in RA patients involves the TP tendon, which is associated with higher titres of RF. Swollen ankles are more specific and better predictors of ultrasound-defined ankle tenosynovitis, which has a directly proportional relationship with disease activity in RA. Disease activity scores should include clinical evaluation of ankles and ultrasound information.

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Power Doppler ultrasonography of symptomatic rheumatoid arthritis ankles revealed a positive association between tenosynovitis and rheumatoid factor

Cited by 16 publications

References 18 publications

Ankle and foot pathologies in early rheumatoid arthritis, what can ultrasound tell us?

Ankle and foot pathologies in early rheumatoid arthritis, what can ultrasound tell us?

Ankle pathologies in patients with inflammatory rheumatic diseases: a clinical and ultrasonographic study

Ankle ultrasound tenosynovitis is a significant predictor of DAS28 – defined rheumatoid arthritis activity

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