Axillary lymph node in rheumatoid arthritis: Does it associate disease activity?

ABSTRACT

Lymph node [LN] in rheumatoid arthritis [RA] has been the focus of recent research work; as it is implicated in disease pathogenesis. Power Doppler ultrasonography [PD-US] is increasingly used for imaging of lymph nodes in conditions other than arthritis. To assess the axillary LN in RA using PD-US, and to correlate the findings to disease activity. Fourteen Consecutive RA patients were subjected to clinical examination and PD-US of axillary LNs, metacarpophalangeal joints [MCPJs] and wrist joints of the ipsilateral sides. LNs were assessed for cortex/hilum [CH] area ratio, longitudinal/transverse [LT] axis ratio and PD signal type. Joints were assessed for grey scale [GS] score and PD score. GS and PD signals were assigned to each joint in accordance with semi-quantitative 0-3 scales for each. DAS28 score was used for disease activity assessment. PD-US detected subclinical LN changes in 24/28 of the examined axillae in RA patients. Changes included hypertrophy mainly of the cortical area and amplification of vascularity of the central type. LN changes did not correlate to DAS28 score; rather correlated to GS and PD scores of ipsilateral wrist and MCPJs as assessed by PD-US. PD-US detects subclinical axillary LN changes in RA patients. These changes do not correlate to DAS28. Axillary LN changes associate signs of synovitis in ipsilateral wrist and MCPJs as assessed by PD-US. Owing to the small number of patients enrolled, results presented in this work should be considered preliminary