Ultrasonography and detection of subclinical joints and tendons involvements in Systemic Lupus erythematosus (SLE) patients: A cross-sectional multicenter study

Salliot, Carine; Denis, Amélie; Dernis, Emmanuelle; Vincent, André; Perdriger, Aleth; Albert, Jean-David; Mraghni, Saloua Mammou; Griffoul-Espitalier, Isabelle; Hamidou, M.; Goff, Benoît Le; Joulin, S. Jousse; Marhadour, Thierry; Richez, Christophe; Poursac, Nicolas; Lazaro, Estebaliz; Rist, Stéphanie; Corondan, Anca; Quinten, Clara; Martaillé, Virginie; Valéry, Antoine; Ducourau, Émilie

doi:10.1016/j.jbspin.2018.01.013

Cited by 22 publications

(22 citation statements)

References 21 publications

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“…Ten (62.5%) out of 16 asymptomatic patients had a sonographic evidence of synovitis. This finding has recently been described in the literature by "subclinical synovitis" [8,9,13,33]. No significant difference was found between both patient groups regarding PD index probably because they had comparable cumulative dose of Cs intake.…”

Section: Discussionsupporting

confidence: 77%

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Involvement of the wrist and hand joints and tendons in an Egyptian systemic lupus erythematosus cohort

Abdel-Moniem¹,

El-Sherif²,

Barakat³

et al. 2020

Egypt Rheumatol Rehabil

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Background Systemic lupus erythematosus (SLE) patients often suffer hand function limitations even in the absence of symptoms related to joint or tendon disorders. Recent researches reported the presence of ultrasonographic (US) subclinical synovitis and tendon involvement in asymptomatic patients. We aimed to assess US patterns in SLE patients and determine their relationship with clinical assessment, disease activity and hand functional status using handheld dynamometry. Results We assessed 30 SLE patients (60 hands) using US; 21 (70%) patient had synovial hypertrophy, 8 (26%) showed a power Doppler (PD) activity, 6 (20%) had erosions and 11 (36.6%) had tendon US abnormality. Both patients with hand arthralgia/arthritis (symptomatic) and patients without arthralgia/arthritis (asymptomatic) had a statistically insignificant difference regarding the global synovitis score (p = 0.2) and disease activity (p = 0.3). However, the symptomatic group had a significantly increased number of joints with effusion (p = 0.04) and tendons involved (p = 0.04). The mean grip strength had a significant negative correlation with SLEDAI-2 K score (rs = − 0.4, p = 0.02) in the total patient group. In the asymptomatic group, a negative correlation was found between both mean grip (rs = − 0.5, p = 0.04) and pinch strength (rs = − 0.6, p = 0.01) with PD index, and mean pinch strength with the Jaccoud’s arthropathy index (rs = − 0.49, p = 0.05). Conclusions SLE patients may have higher subclinical synovitis, erosions and tendon involvement than expected, which may in turn reduce hand grip and pinch strength. Disease activity may also have a negative impact on the hand grip functional strength.

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Section: Discussionsupporting

confidence: 77%

“…Some authors have reported subclinical ultrasonographic (US) synovitis in asymptomatic SLE patients with a high percentage of tendon involvement [8][9][10]. Piga et al in 2016 [11] found that baseline power Doppler (PD) synovitis score predicted MSK flare within 2 years from US examination.…”

Section: Introductionmentioning

confidence: 99%

Involvement of the wrist and hand joints and tendons in an Egyptian systemic lupus erythematosus cohort

Abdel-Moniem¹,

El-Sherif²,

Barakat³

et al. 2020

Egypt Rheumatol Rehabil

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“…The data from this study fulfill many of the criteria in the OMERACT filter for validation of ultrasound as an outcome measure in SLE [19]. Previous data had shown that ultrasound had face validity, and concurrent validity (association with BILAG-2004 and SLEDAI indices [8,20,21]. In the present study, for the first time we demonstrate that it has predictive validity for therapy response.…”

Section: Discussionsupporting

confidence: 69%

Ultrasound to identify lupus patients with inflammatory joint symptoms with a better response to therapy: The USEFUL longitudinal multicentre study

Mahmoud

Zayat

Yusof

et al. 2020

Preprint

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Objective To determine whether SLE patients with inflammatory joint symptoms and ultrasound-detected synovitis achieve better clinical responses to glucocorticoid compared to patients with normal ultrasound scans. Secondary objectives included identification of clinical features predicting ultrasound-synovitis. Methods A longitudinal muticentre study of SLE patients with physician-diagnosed inflammatory joint pain requiring treatment (intramuscular methylprednisolone 120mg) was undertaken. Clinical assessments, patient-reported outcome measures, and bilateral hands and wrist ultrasound data were collected at 0, 2 and 6 weeks post-glucocorticoid. The primary outcome (determined via internal pilot analysis) was EMS-VAS at 2 weeks, adjusted for the baseline value, comparing patients with positive (GS and/or PD) and negative ultrasound. Post-hoc analyses adjusting for fibromyalgia were performed. Results Of 133 patients recruited, 78/133 had positive ultrasound, but only 68% of these had ≥1 swollen joint. Of 66/133 patients with ≥1 swollen joint, 20% had negative ultrasound. Positive ultrasound was associated with joint swelling, symmetrical small joint distribution and active serology. In full analysis set (n=133) there was no difference in baseline-adjusted EMS-VAS at week 2 (-7.7mm 95% CI -19.0mm, 3.5mm, p=0.178). After excluding 32 fibromyalgia patients, response was significantly better in patients with positive ultrasound at baseline (baseline-adjusted EMS-VAS at 2 weeks -12.1 mm, 95% CI -22.2mm, -0.1mm, p=0.049). This difference was greater when adjusted for treatment (-12.8mm (95% CI -22mm, -3mm), p=0.007). Conclusions In SLE patients without fibromyalgia, those with positive ultrasound had a better clinical response to therapy. Imaging-detected synovitis should be used to select SLE patients for therapy and enrich clinical trials.

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“…der Sonografiebefunde und nur geringer Berücksichtigung des Therapieverlaufs. Eine relativ neue Studie aus dem Jahre 2018 von Salliot et al [40] Weitere rheumatologische Sonografie-Indikationen…”

Section: Stellenwert Beim Sle Mit Gelenkbeteiligungunclassified

Sonografie in der Rheumatologie – Update 2020

Ohrndorf¹

2020

Arthritis und Rheuma

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ZUSAMMENFASSUNGDie muskuloskelettale Sonografie ist ein bereits seit vielen Jahren etabliertes Verfahren in der Rheumatologie zur Diagnostik und Verlaufskontrolle von entzündlich rheumatischen Gelenkerkrankungen. Die sonografisch detektierte Synovitis hat eine prognostische Bedeutung sowohl in der Vorhersage einer Arthritis bei sogenannten Risikopatienten mit Arthralgien (ohne Gelenkschwellung) für die rheumatoide Arthritis („at risk for RA“), bei undifferenzierter Arthritis und dem bestehenden Verdacht auf RA sowie bei RA-Patienten in klinischer Remission zur Vorhersage einer radiografischen Progression bzw. eines Schubs. Bei der Psoriasis-Arthritis (PsA) ist die muskuloskelettale Sonografie vor allem hilfreich in der (frühen) Diagnostik, da bisher andere sogenannte Biomarker fehlen. Zusätzlich wird die Sonografie bei anderen rheumatologischen Systemerkrankungen, wie dem primären Sjögren-Syndrom zur Detektion von spezifischen Veränderungen der Speicheldrüsen sowie der Riesenzellarteriitis zur Entzündungsdetektion von Gefäßveränderungen insbesondere der A. temporalis und A. axillaris eingesetzt und hat damit einen bedeutenden Stellenwert in der rheumatologischen Diagnostik erlangt.

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Ultrasonography and detection of subclinical joints and tendons involvements in Systemic Lupus erythematosus (SLE) patients: A cross-sectional multicenter study

Cited by 22 publications

References 21 publications

Involvement of the wrist and hand joints and tendons in an Egyptian systemic lupus erythematosus cohort

Involvement of the wrist and hand joints and tendons in an Egyptian systemic lupus erythematosus cohort

Ultrasound to identify lupus patients with inflammatory joint symptoms with a better response to therapy: The USEFUL longitudinal multicentre study

Sonografie in der Rheumatologie – Update 2020

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