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Tenosynovitis on Ultrasound Predicts RA Development

Discussion in 'Immunology and Rheumatology' started by Dr.Scorpiowoman, Jul 31, 2018.

  1. Dr.Scorpiowoman

    Dr.Scorpiowoman Golden Member

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    Study supports noninvasive, widely available prognostic tool

    [​IMG]

    Musculoskeletal ultrasound has become a more widely used tool in rheumatology clinical practice. A study of early inflammatory arthritis patients shows that ultrasound-defined digit flexor tenosynovitis (TS) was more predictive of subsequent rheumatoid arthritis (RA) than findings of ACPA positivity or ultrasound-defined joint synovitis.

    A cohort of 107 early arthritis patients underwent baseline clinical, laboratory and ultrasound assessment of 19 bilateral joint sites and 16 bilateral tendon compartments. Ultimate outcomes were determined 18 months later using the 2010 ACR/EULAR classification criteria for RA.

    A total of 46 of 107 patients developed persistent RA, 17 patients developed non-RA persistent disease, and 44 patients had resolved their disease at follow-up.

    Ultrasound-defined TS was more likely in RA, but was seen in all groups studied (85% RA 85%, 71% non-RA persistent disease, and 70% resolving). RA patients were more likely to have grayscale and power Doppler changes at PIP 1-5, MCP 1-5, wrist, elbow, MTP 3, and MTP 5 joints.

    In addition, RA patients were more likely to have MTP 2 power Doppler changes, but not grayscale changes alone, compared with patients with resolving arthritis.

    On multi-variate analysis, ultrasound-defined digit flexor TS provided independent predictive data over and above the presence of ACPA and ultrasound-defined joint synovitis.

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