Summary Findings of a Systematic Literature Review of the Ultrasound Assessment of Bone Erosions in Rheumatoid Arthritis

Szkudlarek, Marcin; Terslev, Lene; Wakefield, Richard J.; Backhaus, Marina; Bálint, Péter; Bruyn, G. A. W.; Filippucci, Emilio; Gandjbakhch, Frédérique; Iagnocco, Annamaria; Mandl, Péter; Möller, Ingrid; Naredo, Esperanza; Schmidt, Wolfgang A.; D'Agostino, Maria Antonietta

doi:10.3899/jrheum.141416

Cited by 43 publications

(40 citation statements)

References 52 publications

(52 reference statements)

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“…Plain radiology is a widely used technique for evaluation of shoulder joint in RA regarding detection of damage and follow up, but only identifies late changes . US can help in diagnosing bone erosions . In the current study, we explored the point of US capability to detect humeral erosions and found that it was better than plain radiology and the results were significant ( P < .001).…”

Section: Discussionsupporting

confidence: 92%

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Ultrasound versus magnetic resonance imaging in the evaluation of shoulder joint pathologies in a cohort of rheumatoid arthritis patients

et al. 2019

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Background: Rheumatoid arthritis (RA) is a systemic autoimmune disease that has a great impact on different joints, may result in their destruction and loss of function.Although the shoulder is affected in a large portion of patients with RA, it does not receive much attention during the follow up of RA. The precise diagnosis of shoulder pain in RA is a clinical challenge and benefits from a reliable imaging modality to detect its exact origin. Aim:To determine the diagnostic accuracy of ultrasound (US) in detecting shoulder joint pathologies in RA, considering magnetic resonance imaging (MRI) as the gold standard. Materials and Methods:This cross-sectional, observational study was carried out on 30 RA patients complaining of unilateral or bilateral shoulder pain. Patients were subjected to history taking, clinical shoulder examination, plain X-ray, US examination following a standardized protocol, and MRI. The results were correlated with each other. Results:In comparison with the MRI findings, US showed high accuracy in terms of sensitivity (Sn) and specificity (Sp) in supraspinatus tendinopathy (Sn 96.6%; Sp 93.3%), biceps tenosynovitis (Sn 87.5%; Sp 97.6%), subacromial-subdeltoid bursitis (Sn 72.7%; Sp 95.7%), humeral erosions (Sn 90.5%; Sp 97.3%), and acromioclavicular osteoarthritis (Sn 85.7%; Sp 95.7%). In terms of reliability, the agreement between US and MRI was almost perfect (κ = .9, P < .001). Conclusion:US may have a role as the initial imaging modality in RA patients with shoulder pain, as it is highly sensitive and specific in detecting different pathological abnormalities of the shoulder. K E Y W O R D S MRI, rheumatoid arthritis, shoulder, ultrasound | 2159 ABDELZAHER Et AL.

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Section: Discussionsupporting

confidence: 92%

“…US is increasingly being used as a tool by rheumatologists for the assessment of patients with suspected or proven RA. Its many advantages include its wide availability, supplementing the clinical examination with important information …”

Section: Discussionsupporting

confidence: 88%

Ultrasound versus magnetic resonance imaging in the evaluation of shoulder joint pathologies in a cohort of rheumatoid arthritis patients

et al. 2019

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“… 4b n/a 9.6 (7–10) Ultrasonography can be applied in the diagnosis of inflammation of joints* and soft tissue**. 2 * [ 47 , 48 ] ** [ 49 , 50 ] 9.4 (7–10) When clinical examination is inconclusive in the diagnosis of inflammation of joints and soft tissue, ultrasonography should be considered. *When ultrasonography is inconclusive, additional diagnostic imaging (MRI or CT scan) can be considered.…”

Section: Resultsmentioning

confidence: 99%

Multidisciplinary recommendations for diagnosis and treatment of foot problems in people with rheumatoid arthritis

Tenten-Diepenmaat

Leeden

Vlieland

et al. 2018

Journal of Foot and Ankle Research

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BackgroundFoot problems in people with rheumatoid arthritis (RA) are highly prevalent and have a substantial impact on quality of life. Healthcare professionals from various professions can be involved in the management of these foot problems. There is currently no consensus on optimal management. Therefore, the aim of the present study was to develop multidisciplinary recommendations for the management of foot problems in people with RA in the Netherlands.MethodsThe recommendations were based on research evidence and consensus among experts, following published strategies for the development of practice recommendations. The expert group was composed of 2 patients and 22 experienced professionals (rheumatologists, rehabilitation physicians, orthopaedic surgeons, specialized nurses, podiatrists, orthopaedic shoe technicians, pedicurists, and researchers) in the Netherlands. For each developed recommendation i) the level of evidence was determined, and ii) the level of agreement (among the expert group) was set by an anonymous voting procedure using a numeric rating scale. The mean and range of the level of agreement for each recommendation was calculated. A recommendation was approved when ≥70% of the expert group voted an NRS-agreement ≥7.ResultsIn total, 41 recommendations were developed. Two recommendations concerned a framework for diagnosis and treatment. Thirty-nine recommendations on foot care were developed: seven on diagnosis (including check-ups of feet and shoes and diagnostic imaging), 27 on treatment (including corticosteroid injections, foot surgery, therapeutic shoes, foot orthoses, exercise therapy, toe-orthoses and toenail-braces, treatment of toenails and skin), four on communication, and one on organisation of RA-related footcare. All recommendations were approved by the expert group. The percentage score of NRS-agreement ≥7 ranged from 80 to 100%.ConclusionsThese are the first published multidisciplinary recommendations specific to the management of foot problems in people with RA. Multidisciplinary recommendations can provide guidance in timely referrals and access to adequate footcare. More research is needed to strengthen the evidence on diagnosis and treatment of RA-related foot problems. These national recommendations may be a first step towards developing international multidisciplinary recommendations for the management of foot problems in RA.Electronic supplementary materialThe online version of this article (10.1186/s13047-018-0276-z) contains supplementary material, which is available to authorized users.

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“…Одним из частых проявлений РА является поражение позвоночника [6], которое значительно ухудшает качество жизни таких пациентов [15]. Поражение межпозвоночных сочленений и дугоотростчатых суставов позвоночника при РА позволяют диагностировать обзорная рентгеноспондилография и сонография, компьютерная и магнитно-резонансная томография [9,12]. Для таких больных весьма характерна атлантоаксиальная вертебральная неустойчивость [13], методом выбора диагностики которой является именно магнитно-резонансная томография [7].…”

Section: Introductionunclassified

Поражение Позвоночника При Ревматоидном Артрите

Syniachenko¹,

Selezniova²,

Perepada³

et al. 2021

PJS

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Донецкий национальный медицинский университет имени М. Горького, г. Лиман, Украина 2 Днепропетровская медицинская академия, г. Днепропетровск, Украина ПОРАЖЕНИЕ ПОЗВОНОЧНИКА ПРИ РЕВМАТОИДНОМ АРТРИТЕ Резюме. Ревматоидный артрит (РА) относится к наиболее частым воспалительным заболеваниям суставов, приводящим к стойкой инвалидизации и ранней смерти больных, а одним из частых проявлений РА является поражение позвоночника, которое значительно ухудшает качество жизни таких пациентов. Цель исследования: оценить поражение позвоночника у больных с разными вариантами течения РА и факторы, его определяющие. Материал и методы. Под наблюдением находился 131 больной РА в возрасте от 18 до 79 лет (в среднем 45 лет), среди которых было 18 % мужчин и 82 % женщин. Длительность заболевания составила 10 лет, I рентгенологическая стадия артрита установлена в 8 % случаев заболевания, II-в 38 %, III-в 35 %, IV-в 19 %, серопозитивность по ревматоидному фактору отмечена у 77 % от числа обследованных пациентов, а по наличию антител к цитруллиновому циклическому пептиду-у 3/4. Внесуставная (системная) форма болезни имела место в 43 % наблюдений, системный остеопороз-в 67 %. Результаты. Поражение позвоночника в виде остеохондроза и спондилоартроза наблюдается у 1/2 от числа больных РА, причем клинически манифестно протекает в 35 % случаев, что прямо связано с возрастом пациентов, вовлечением в процесс лучезапястных, локтевых, тазобедренных и крестцовоподвздошных суставов, наличием системного остеопороза и тендовагинитов, сенсорных и моторных расстройств, обусловленных периферической нейропатией. Соотношение частоты механического, дисфиксационного, дисгемического и воспалительного характера боли в позвоночнике при РА составляет 1 : 2 : 6 : 14. На рентгенограммах обнаруживаются оссификация наружных слоев межпозвоночных дисков и формирование синдесмофитов, а также спондилодисцит. Вовлечение дугоотростчатых суставов характеризуется нечеткостью суставных поверхностей и сужением щелей. Вертебральная патология влияет на признаки патологии сердца (изменения электрической проводимости, размеры камер, диастолическую функцию левого желудочка), вегетативные изменения и тяжесть нейропатии, а прогностическими показателями являются уровни в крови ревматоидного фактора и С-реактивного протеина. Выводы. Спондилопатия является частым проявлением РА, взаимосвязана со многими клинико-лабораторными признаками заболевания. В будущем таким больным будет полезно активное раннее выявление патологии позвоночника для своевременных реабилитационных мероприятий. Ключевые слова: артрит ревматоидный, позвоночник.

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Summary Findings of a Systematic Literature Review of the Ultrasound Assessment of Bone Erosions in Rheumatoid Arthritis

Cited by 43 publications

References 52 publications

Ultrasound versus magnetic resonance imaging in the evaluation of shoulder joint pathologies in a cohort of rheumatoid arthritis patients

Ultrasound versus magnetic resonance imaging in the evaluation of shoulder joint pathologies in a cohort of rheumatoid arthritis patients

Multidisciplinary recommendations for diagnosis and treatment of foot problems in people with rheumatoid arthritis

Поражение Позвоночника При Ревматоидном Артрите

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