Value of musculoskeletal ultrasound examination in the evaluation of rheumatoid arthritis

Fengxia JIN; Jianfeng LIU

ABSTRACT

Objective:

To investigate the value of musculoskeletal ultrasound examination in the evaluation of rheumatoid arthritis.

Methods:

A total of 89 patients with rheumatoid arthritis who received treatment in Zhejiang Rongjun Hospital from January 2020 to January 2023 were included in this study. According to the Disease Activity Score-28 for Rheumatoid Arthritis, these patients were divided into a low activity group ( n = 32), a medium activity group ( n = 36), and a high activity group ( n = 21). An additional 32 healthy controls who concurrently underwent physical examinations in Zhejiang Rongjun Hospital were included in the control group. All participants underwent a musculoskeletal ultrasound examination. Serum interleukin-1β, interleukin-6, and interleukin-23 levels were determined by an enzyme linked immunosorbent assay.

Results:

In the rheumatoid arthritis group, semi-quantitative scores of musculoskeletal ultrasound in terms of joint effusion, bone erosion, synovial blood flow signal, synovial hyperplasia, and total scores were (1.53 ± 0.36) points, (1.70 ± 0.45) points, (1.75 ± 0.38) points, (1.98 ± 0.42) points, and (6.97 ± 1.43) points, which were significantly higher than (0.11 ± 0.03) points, (0.14 ± 0.02) points, (0.07 ± 0.03) points, (0.15 ± 0.04) points, and (0.47 ± 0.08) points in the control group ( t = 22.23, 19.55, 24.92, 24.54, 25.63, all P < 0.05). Serum interleukin-1β, interleukin-6, and interleukin-23 levels in the rheumatoid arthritis group were (66.49 ± 15.45) ng/L, (12.33 ± 3.27) ng/L, and (206.85 ± 24.37) ng/L], which were significantly higher than (15.42 ± 4.36) ng/L, (6.58 ± 1.39) ng/L, and (124.52 ± 18.29) ng/L in the control group ( t = 18.39, 9.62, 17.41, all P < 0.05). The semi-quantitative scores of musculoskeletal ultrasound in terms of joint effusion, bone erosion, synovial blood flow signal, synovial hyperplasia, and total scores in the high activity group were significantly higher than those in the medium activity and low activity groups, and the semi-quantitative scores of musculoskeletal ultrasound in terms of joint effusion, bone erosion, synovial blood flow signal, synovial hyperplasia, and total scores in the medium activity group were significantly higher than those in the low activity group (all P < 0.05). Serum interleukin-1β, interleukin-6, and interleukin-23 levels in the high activity group were significantly higher than those in the medium activity and low activity groups, and the scores in the medium activity group were significantly higher than those in the low activity group (all P < 0.05). According to Spearman analysis, the semi-quantitative total score of musculoskeletal ultrasound was positively correlated with the severity of disease activity, interleukin-1β, interleukin-6, and interleukin-23 ( r = 0.68, 0.57, 0.52, 0.62, P < 0.05).

Conclusion:

Musculoskeletal ultrasound is of good value in the evaluation of rheumatoid arthritis. Musculoskeletal ultrasound results are closely related to the degree of rheumatoid arthritis and inflammatory factors.