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Ultrasound detection of subclinical synovitis in rheumatoid arthritis patients in clinical remission: a new reduced-joint assessment in 3 target joints.
Picchianti Diamanti, Andrea; Navarini, Luca; Messina, Filippo; Markovic, Milica; Arcarese, Luisa; Basta, Fabio; Meneguzzi, Giorgia; Margiotta, Domenico Paolo Emanuele; Laganà, Bruno; Afeltra, Antonella; D'Amelio, Raffaele; Iagnocco, Annamaria.
Afiliación
  • Picchianti Diamanti A; Department of Clinical and Molecular Medicine, S. Andrea University Hospital, School of Medicine and Psychology, Sapienza University, Rome, Italy.
  • Navarini L; ImmunoRheumatology Unit, Policlinico Universitario Campus Biomedico, Rome, Italy.
  • Messina F; Department of Clinical and Molecular Medicine, S. Andrea University Hospital, School of Medicine and Psychology, Sapienza University, Rome, Italy.
  • Markovic M; Department of Clinical and Molecular Medicine, S. Andrea University Hospital, School of Medicine and Psychology, Sapienza University, Rome, Italy.
  • Arcarese L; ImmunoRheumatology Unit, Policlinico Universitario Campus Biomedico, Rome, Italy.
  • Basta F; ImmunoRheumatology Unit, Policlinico Universitario Campus Biomedico, Rome, Italy.
  • Meneguzzi G; Department of Clinical and Molecular Medicine, S. Andrea University Hospital, School of Medicine and Psychology, Sapienza University, Rome, Italy.
  • Margiotta DPE; ImmunoRheumatology Unit, Policlinico Universitario Campus Biomedico, Rome, Italy.
  • Laganà B; Department of Clinical and Molecular Medicine, S. Andrea University Hospital, School of Medicine and Psychology, Sapienza University, Rome, Italy.
  • Afeltra A; ImmunoRheumatology Unit, Policlinico Universitario Campus Biomedico, Rome, Italy.
  • D'Amelio R; Department of Clinical and Molecular Medicine, S. Andrea University Hospital, School of Medicine and Psychology, Sapienza University, Rome, Italy.
  • Iagnocco A; Dipartimento Scienze Cliniche e Biologiche, Università degli Studi di Torino, Italy. annamaria.iagnocco1@gmail.com.
Clin Exp Rheumatol ; 36(6): 984-989, 2018.
Article en En | MEDLINE | ID: mdl-29998842
ABSTRACT

OBJECTIVES:

The ability of ultrasound (US) to identify subclinical joint inflammation in rheumatoid arthritis (RA) patients in remission has been already reported. Nonetheless, current studies present a lack of homogeneity in patient's characteristics and number of joints assessed by US. The aim of this study was to identify a reduced set of target joints to be scanned in RA patients in clinical remission in order to detect subclinical synovitis.

METHODS:

Forty RA patients in clinical remission (DAS28 ≤2.6) for at least 3 months underwent an US examination of 18 joints wrist, II-III-IV-V metacarpophalangeal (MCP) and II-III-IV-V metatarsophalangeal joints bilaterally. The presence of synovial hypertrophy (SH) and power-Doppler (PD) signal was registered following the OMERACT definitions and was graded according to a 4-point scale (0-3). Then, by applying a process of data reduction based on the frequency of joint involvement, a reduced assessment was obtained.

RESULTS:

Twenty (50%) subjects had at least one joint affected by active synovitis; 17.5% presented grade 1 PD and 32.5% grade 2 PD. The joints most frequently affected by active synovitis were the wrists (75%) and the II MCP joints (55%). After data reduction, the evaluation of 3 joints (both wrists and the II MCP of the dominant hand) obtained a sensitivity of 90% for the detection of subclinical synovitis.

CONCLUSIONS:

The US scan of 3 target joints showed a high sensitivity in detecting subclinical active synovitis in RA patients in clinical remission and can be feasible in the routine assessment of these patients.
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Base de datos: MEDLINE Asunto principal: Artritis Reumatoide / Membrana Sinovial / Sinovitis / Ultrasonografía Doppler / Antirreumáticos Tipo de estudio: Diagnostic_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Clin Exp Rheumatol Año: 2018 Tipo del documento: Article
Buscar en Google
Base de datos: MEDLINE Asunto principal: Artritis Reumatoide / Membrana Sinovial / Sinovitis / Ultrasonografía Doppler / Antirreumáticos Tipo de estudio: Diagnostic_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Clin Exp Rheumatol Año: 2018 Tipo del documento: Article