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Tenosynovitis ultrasound variables superior to clinical variables for prediction of early RA
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The use of ultrasound-defined tenosynovitis was more strongly predictive of rheumatoid arthritis and able to distinguish non-rheumatoid arthritis persistent disease compared with clinical and serological variables, according to research presented at the European League Against Rheumatism Annual European Congress of Rheumatology, here.
Researchers in the OMERACT Ultrasound Task Force studied 107 patients with clinically apparent synovitis in at least one joint and a duration of symptoms lasting at least 3 months. Ultrasound was performed and diagnosis was determined according to 1987 American College of Rheumatology criteria after 18 months.
Ultrasound assessment of gray scale and power Doppler was performed by an ultrasound assessor blinded to the study details. A Siemens Acuson Antares scanner with a 5-MHz to 13-MHz linear array transducer was used to assess tenosynovitis at 16 tendon regions, including bilateral fingers in extensor and flexor compartments; wrists at extensor and flexor compartments; shoulders at the biceps tendon; and ankles at the anterior extensors, peroneals and posterior tibialis. Gray scale and power Doppler definitions of tenosynovitis were based on recommendations from the OMERACT Ultrasound Task Force and were recorded as binary outcomes. These predictive values were compared with serological and clinical observations.
At follow-up, 43 patients developed rheumatoid arthritis (RA), 20 developed non-RA persistent disease and 44 had a resolution of symptoms. Variables observed with ultrasound were shown to be superior to clinical variables, such as self-reported early morning stiffness, according to the researchers.
“There is a wealth of evidence that the clinical signs and symptoms of RA may be preceded by a preclinical phase lasting several years, and this preclinical phase is likely to represent an important therapeutic window within which clinical outcomes can be dramatically improved,” Andrew Filer, MD, PhD, of the Rheumatology Research Group, University of Birmingham, UK, said in a press release. “We, therefore, set out to explore the ability of ultrasound-defined tenosynovitis to predict very early RA during the earliest undifferentiated phase of disease.” - by Shirley Pulawski
Reference:
Sahbudin, I, et al. Paper #OP0015. Presented at: European League Against Rheumatism Annual European Congress of Rheumatology; June 10-13, 2015; Rome.
Disclosure: The researchers report no relevant financial disclosures.