Ultrasonographic examination of rheumatoid arthritis patients who are free of physical synovitis: power Doppler subclinical synovitis is associated with bone erosion

Kawashiri, Shin‐ya; Suzuki, Takahisa; Nakashima, Yoshikazu; Horai, Yoshiro; Okada, Akitomo; Iwamoto, Naoki; Ichinose, Kunihiro; Tamai, Mami; Arima, Kei; Nakamura, Hideki; Origuchi, Tomoki; Uetani, Masataka; Aoyagi, Kiyoshi; Eguchi, Katsumi; Kawakami, Atsushi

doi:10.1093/rheumatology/ket405

Cited by 59 publications

(36 citation statements)

References 37 publications

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“…This confirms the general view that active synovitis revealed in PD is correlated with systemic inflammation [21,26]. Both Scirè et al [21] and Kawashiri et al [24] did not find any correlation between ESR values and the intensity of changes in power Doppler, which is also confirmed by us. A study by Xiao et al [19] revealed the presence of a correlation between CRP, ESR, and ACPA with the intensity of synovial thickening (GS).…”

Section: Discussionsupporting

confidence: 89%

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The initial ultrasonographic examination of hands and feet joints in patients with early rheumatoid arthritis

Ponikowska¹,

Wiland²

2015

Reumatologia

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Objectives: The aim was to assess of the morphology, intensity, and activity of changes in the first ultrasonographic (US) examination of hands and feet in patients with early arthritis (lasting up to 12 months) who were ultimately diagnosed with rheumatoid arthritis (RA). An attempt was made to demonstrate a correlation between the intensity of lesions in US and selected laboratory parameters. Material and methods: Ultrasonographic examination was performed using a LOGIC GE 500 device on a group of 60 patients with arthritis (46 women, 14 men) aged 18-80, previously untreated. In total, 3120 hand and feet joints were examined. The assessment focused on the presence of joint effusion, synovial proliferation and power Doppler signals (assessed on a semi-quantitative scale). Each patient underwent laboratory tests, necessary for making a diagnosis. In order to analyze the correlations between changes in US and laboratory parameters, erythrocyte sedimentation rate (ESR), reactive protein test (CRP), rheumatoid factor (RF), and anti-citrullinated protein antibodies (ACPAs) were used. Results: In the study group, the average duration of arthritis symptoms until the first US examination was 5.6 months. Among the 3120 examined hand and foot joints, deviations from the norm appeared in 1093 joints, synovial hypertrophy was found in 471 joints (grade 1 synovial hypertrophy was reported most frequently), while presence of signal in Power Doppler was revealed in 261 joints (grade 1 was observed most frequently). A statistically significant correlation was found between the intensity of changes in Power Doppler and CRP concentration. Conclusions: In patients with increased concentrations of CRP, we may expect arthritis of higher intensity, therefore, in order to prevent the progression of destructive changes, it is necessary to quickly implement effective disease-modifying antirheumatic treatment. The conducted research showed that the activity of joint inflammation is not affected by the values of ESR and the presence of RF or ACPAs.

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Section: Discussionsupporting

confidence: 89%

“…This should be taken into consideration when making decisions concerning the use of DMARDs. According to the data from literature, PD signal was present even in patients in clinical remission, which is a predictor of fast radiological damage progression in the involved joints [22][23][24].…”

Section: Discussionmentioning

confidence: 99%

The initial ultrasonographic examination of hands and feet joints in patients with early rheumatoid arthritis

Ponikowska¹,

Wiland²

2015

Reumatologia

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“…[21] были изуче-ны особенности субклинического синовита по данным ЭД у больных РА с клинической ремиссией. В исследование были включены 29 пациентов с РА.…”

Section: таблицаunclassified

“…При этом кор-реляции между УЗ-признаками синовита и концентрацией провоспалительных цитокинов (ФНОα, ИЛ6, ИЛ8, ИЛ17A, ИЛ17F, ИЛ18, ИЛ20, ИЛ23 и ИЛ33) также не отме-чено. В другом исследовании [21] у 29 пациентов с РА в клинической ремиссии на фоне успешной терапии была обнаружена связь персистирующего субклинического вос-Ф о р у м м о л о д ы х у ч е н ы х паления с наличием эрозий, однако при этом уровень био-маркеров (MMП3, СЭФР, ANG-2 и sRANKL) в группах с изменениями разной степени интенсивности, выявлен-ными по данным ЭД, не различался. Противоречивость результатов обусловлена тем, что большинство цитокинов в разные периоды времени могут оказывать стимулирующее или ингибирующее влияние на продукцию других цитокинов.…”

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

Alekseeva¹

2018

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“…Likewise, the degree of the PD signal at baseline is a predictor for radiologic progression in early RA [22,36,65,79,85,86] as well as in longstanding RA [52,69,[87][88][89][90]. In this respect, subclinical active synovitis could be considered a surrogate marker to define the disease activity or a complete remission status in treated RA patients [18,79,[91][92][93].…”

Section: Clinical Remission Versus Imaging Remissionmentioning

confidence: 99%

Concepts in monitoring the treatment in rheumatoid arthritis â€“ the role of musculoskeletal ultrasound. Part I: synovitis.

Micu¹,

Fodor

2015

Med Ultrason

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Rheumatoid arthritis (RA) is an incurable chronic inflammatory disease associated with significant functional impairment and disability, linked to inflammatory and structural articular and peri-articular damage. Structural damage occurs rapidly in RA if inflammation is not efficiently suppressed. Identification of patients with high risk to develop RA followed by an early application of efficient medications and standard 'treat to target' recommendations allow a better management aiming remission. Over the last 15 years musculoskeletal ultrasound (MSUS) has proved to detect subclinical inflammatory lesions; thus, targeting therapy to imaging delivered information may provide superior outcomes and a more rapid response to therapy detection in comparison with clinical examination alone. This review provides an insight into the importance of MSUS in quantifying disease activity and monitoring of therapies in RA patients.

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Ultrasonographic examination of rheumatoid arthritis patients who are free of physical synovitis: power Doppler subclinical synovitis is associated with bone erosion

Abstract: PD subclinical synovitis correlates with several clinical characteristics, whereas conventional serum biomarkers are not useful for indicating the presence of subclinical PD synovitis.

Cited by 59 publications

References 37 publications

The initial ultrasonographic examination of hands and feet joints in patients with early rheumatoid arthritis

The initial ultrasonographic examination of hands and feet joints in patients with early rheumatoid arthritis

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

Concepts in monitoring the treatment in rheumatoid arthritis â€“ the role of musculoskeletal ultrasound. Part I: synovitis.

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