Ultrasound characterization of the nail bed in patients with systemic lupus erythematosus.

OBJECTIVE: To characterize the ultrasound findings of the nail plate and nail bed in systemic lupus erythematosus (SLE) and its association with nail dystrophy. METHODS: Thirty-two SLE patients, 36 patients with osteoarthritis (OA) and 20 healthy individuals were studied. High-frequency linear ultrasound was performed in nails of the second to fifth fingers in all participants. Disease activity (SLEDAI-2K index), accrued organ damage (SLICC/ACR index), autoantibody profile, and Raynaud's phenomenon were also assessed in SLE patients. RESULTS: Nail bed thickness in SLE patients was higher than in healthy individuals (1.25 ± 0.31 mm vs 1.17 ± 0.29 mm; P = 0.01) but lower than in OA (1.39 ± 0.37 mm; P < 0.001), while nail plate thickness was similar among groups. Nail dystrophy was found more frequently in SLE and OA than in healthy individuals. SLE patients with nail dystrophy were older than their counterparts with no dystrophy (39.4 ± 10.4 years vs 27.8 ± 5.6 years; P = 0.004), although nail dystrophy showed no association with SLICC/ACR, SLEDAI-2K, nail bed vascularity, or autoantibodies. CONCLUSIONS: Nail bed in SLE patients is thicker than in healthy individuals but thinner than in OA patients. Nail dystrophy in SLE is associated with advanced age, but not with accrued organ damage, disease activity, Raynaud's phenomenon, or DIP synovitis assessed by ultrasound.

Reliability of ultrasound grading traditional score and new global OMERACT-EULAR score system (GLOESS): results from an inter- and intra-reading exercise by rheumatologists.

This study aims to test the reliability of ultrasound to graduate synovitis in static and video images, evaluating separately grayscale and power Doppler (PD), and combined. Thirteen trained rheumatologist ultrasonographers participated in two separate rounds reading 42 images, 15 static and 27 videos, of the 7-joint count [wrist, 2nd and 3rd metacarpophalangeal (MCP), 2nd and 3rd interphalangeal (IPP), 2nd and 5th metatarsophalangeal (MTP) joints]. The images were from six patients with rheumatoid arthritis, performed by one ultrasonographer. Synovitis definition was according to OMERACT. Scoring system in grayscale, PD separately, and combined (GLOESS-Global OMERACT-EULAR Score System) were reviewed before exercise. Reliability intra- and inter-reading was calculated with Cohen's kappa weighted, according to Landis and Koch. Kappa values for inter-reading were good to excellent. The minor kappa was for GLOESS in static images, and the highest was for the same scoring in videos (k 0.59 and 0.85, respectively). Excellent values were obtained for static PD in 5th MTP joint and for PD video in 2nd MTP joint. Results for GLOESS in general were good to moderate. Poor agreement was observed in 3rd MCP and 3rd IPP in all kinds of images. Intra-reading agreement were greater in grayscale and GLOESS in static images than in videos (k 0.86 vs. 0.77 and k 0.86 vs. 0.71, respectively), but PD was greater in videos than in static images (k 1.0 vs. 0.79). The reliability of the synovitis scoring through static images and videos is in general good to moderate when using grayscale and PD separately or combined.

Evaluación ecográfica de la glándula salival desde la perspectiva de reumatología / Evaluation of salivary gland by ultrasound from the perspective of rheumatology

The major salivary glands have multiple functions as wet oral mucosa, facilitate swallowing of food, digestion of carbohydrates, control the bacterial flora of the mouth, promote tooth mineralization and immune function by secretory IgA, which they can be altered by some conditions like autoimmune diseases or tumor. Ultrasound is a useful tool for the study of these glands, with the advantage of being safe, inexpensive, reproducible, noninvasive technique. In this review, we make a description of the anatomy and ultrasound anatomy of the major salivary glands and a brief description of the usefulness of elastography in some pathologies of these glands...

Las glándulas salivales mayores tienen múltiples funciones, como humedecer la mucosa oral, facilitar la deglución de alimentos, digestión de carbohidratos, control sobre la flora bacteriana de la boca, favorecen la mineralización de los dientes así como la función inmunológica por la secreción de IgA, las cuales pueden verse alteradas por la afección de enfermedades autoinmunes o tumorales. La ecografía es una técnica útil para el estudio de estas glándulas, con la ventaja de ser inocua, de bajo costo, reproducible y no invasiva. En esta revisión se hacen una descripción de la anatomía y sonoanatomía de las glándulas salivales mayores y una breve descripción de la utilidad de la elastografía en algunas patologías de estas glándulas...