Subclinical synovitis in primary Sjogren's syndrome: an ultrasonographic study

Iagnocco, Annamaria; Modesti, M; Priori, Roberta; Alessandri, Cristiano; Perella, Chiara; Takanen, Silvia; Valesini, Guido

doi:10.1093/rheumatology/keq076

Cited by 26 publications

(11 citation statements)

References 15 publications

(13 reference statements)

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“…In the present study, erosions were detected in the radiocarpal and midcarpal joints of three patients with pSS (18% prevalence). In analogy with our results, Iagnocco and colleagues recently analyzed US changes in the hands and wrists of 32 patients with pSS [16]. Of a total of 960 joints evaluated, synovial proliferation was found in 5.1%, joint effusion in 3.4%, PD signals in 2%, and bone erosions in 0.2% (erosions were present in the wrists of a single patient with pSS.)…”

Section: Discussionsupporting

confidence: 78%

“…To date, few studies aimed at characterizing the US pattern of joint involvement in patients with pSS have been conducted [16–18]. These are consistent in demonstrating significant involvement targeting the synovial membrane as featured by synovial hypertrophy, joint effusion, and intra-articular power Doppler (PD); however, they provide no strong data on the existence of bone erosions.…”

Section: Introductionmentioning

confidence: 99%

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Joint Involvement in Primary Sjögren’s Syndrome: An Ultrasound “Target Area Approach to Arthritis”

Amezcua-Guerra

Hofmann

Vargas

et al. 2013

BioMed Research International

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Objective. To characterize the ultrasound (US) pattern of joint involvement in primary Sjögren's syndrome (pSS). Methods. Seventeen patients with pSS, 18 with secondary Sjögren's syndrome (sSS), and 17 healthy controls underwent US examinations of various articular regions. Synovitis (synovial hypertrophy/joint effusion), power Doppler (PD) signals, and erosions were assessed. Results. In patients with pSS, synovitis was found in the metacarpophalangeal joints (MCP, 76%), wrists (76%), and knees (76%), while the proximal interphalangeal joints, elbows, and ankles were mostly unscathed. Intra-articular PD signals were occasionally detected in wrists (12%), elbows (6%), and knees (6%). Erosions were evident in the wrists of three (18%) patients with pSS, one of these also having anti-cyclic citrullinated peptide (anti-CCP) antibodies. While US synovitis does not discriminate between sSS and pSS, demonstration of bone erosions in the 2nd MCP joints showed 28.8% sensitivity and 100% specificity for diagnosing sSS; in comparison, these figures were 72.2 and 94.1% for circulating anti-CCP antibodies. Conclusions. In pSS, the pattern of joint involvement by US is polyarticular, bilateral, and symmetrical. Synovitis is the US sign most commonly found in patients with pSS, especially in MCP joints, wrists, and knees, and bone erosions also may occur.

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Section: Discussionsupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Joint Involvement in Primary Sjögren’s Syndrome: An Ultrasound “Target Area Approach to Arthritis”

Amezcua-Guerra

Hofmann

Vargas

et al. 2013

BioMed Research International

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“…Recently, US has been shown to be of value in revealing subclinical joint and tendon inflammation in patients with other inflammatory conditions such as arthritis [22,23], psoriasis [24] and Sjögren's syndrome [25]. This prompted us to investigate its ability to identify the involvement of the hyaline cartilage, tendons and joints in individuals with asymptomatic hyperuricemia and no signs of inflammation or musculoskeletal complaints.…”

Section: Discussionmentioning

confidence: 99%

Joint and tendon subclinical involvement suggestive of gouty arthritis in asymptomatic hyperuricemia: an ultrasound controlled study

Pineda

Amezcua-Guerra

Solano³

et al. 2011

Arthritis Res Ther

211

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IntroductionIn this study, we aimed to investigate ultrasonographic (US) changes suggestive of gouty arthritis in the hyaline cartilage, joints and tendons from asymptomatic individuals with hyperuricemia.MethodsWe conducted a cross-sectional, controlled study including US examinations of the knees and first metatarsal-phalangeal joints (first MTPJs), as well as of the tendons and enthesis of the lower limbs. Differences were estimated by χ2 or unpaired t-tests as appropriate. Associations were calculated using the Spearman's correlation coefficient rank test.ResultsFifty asymptomatic individuals with hyperuricemia and 52 normouricemic subjects were included. Hyperechoic enhancement of the superficial margin of the hyaline cartilage (double contour sign) was found in 25% of the first MTPJs from hyperuricemic individuals, in contrast to none in the control group (P < 0.0001). Similar results were found on the femoral cartilage (17% versus 0; P < 0.0001). Patellar enthesopathy (12% versus 2.9%; P = 0.01) and tophi (6% versus 0; P = 0.01) as well as Achilles enthesopathy (15% versus 1.9%; P = 0.0007) were more frequent in hyperuricemic than in normouricemic individuals. Intra-articular tophi were found in eight hyperuricemic individuals but in none of the normouricemic subjects (P = 0.003).ConclusionsThese data demonstrate that morphostructural changes suggestive of gouty arthritis induced by chronic hyperuricemia frequently occur in both intra- and extra-articular structures of clinically asymptomatic individuals.

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“…Ce syndrome est très fréquent au cours du syndrome de Sjögren (au moins 1/3 des patients) . Des synovites non spécifiques prédominant aux poignets [157] peuvent également être observées en IRM [39] et échographie [274] . Il s'agit d'une polyarthrite distale, bilatérale et symétrique, classiquement non érosive [132,136] bien que de petites érosions non évolutives soient parfois détectables en échographie et radiographie [9,11] .…”

Section: Manifestations Systémiquesunclassified

“…■ des arthralgies ou une polyarthrite (45-50 % des cas) . Elles seraient plus fréquentes chez des patients présentant des anticorps anti-SSA et un facteur rhumatoïde positif [157] . Des synovites non spécifiques prédominant aux poignets [157] peuvent également être observées en IRM [39] et échographie [274] .…”

Section: Manifestations Systémiquesunclassified

Maladies systémiques et vascularites

Mouly¹,

Hachulla²,

Lefèbvre³

et al. 2013

Imagerie Musculosquelettique : Pathologies Générales

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Subclinical synovitis in primary Sjogren's syndrome: an ultrasonographic study

Abstract: In pSS patients, MSUS may be considered a useful tool for detecting synovitis since articular involvement can often be silent but correlated with SSDDI.

Cited by 26 publications

References 15 publications

Joint Involvement in Primary Sjögren’s Syndrome: An Ultrasound “Target Area Approach to Arthritis”

Joint Involvement in Primary Sjögren’s Syndrome: An Ultrasound “Target Area Approach to Arthritis”

Joint and tendon subclinical involvement suggestive of gouty arthritis in asymptomatic hyperuricemia: an ultrasound controlled study

Maladies systémiques et vascularites

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