Spain: Ultrasound (US) can detect subclinical inflammatory characteristics in clinically suspicious arthralgia (CSA) patients, particularly those with higher ESR and ACPA levels. Only power Doppler (PD) tenosynovitis at baseline US evaluation was revealed to be an independent predictor of the development of rheumatoid arthritis (RA) and inflammatory arthritis (IA) in CSA patients. These findings were given by Juan Molina Collada and the team, which then later got published in BMC Arthritis Research and Therapy.
The goal of this study was to see if PD ultrasonography might predict the onset of rheumatoid arthritis in individuals with CSA.
This study was a 1-year retrospective examination of a US unit cohort. Patients with CSA who had not previously been diagnosed with IA were included in the study. All were subjected to bilateral US examinations of the hands and/or feet in accordance with EULAR recommendations. In the United States, active inflammation was defined as PD synovitis and/or tenosynovitis 1 in any location. Six months after the US evaluation, RA was diagnosed using clinical criteria. To study potential predictors of RA development, univariate and multivariate logistic regression models were used.
The key findings of this study were as follow:
1. A total of 110 CSA patients (80 females, mean age 53.6 years) were studied. 14 (12.7%) developed RA and 34 (30.9%) developed IA after 6 months of follow-up.
2. Active inflammation was found in 38 (34.5%) of the patients in the United States (28.2% showed PD synovitis and 18.2% PD tenosynovitis).
3. ACPA and ESR were substantially linked with the detection of active inflammation in the United States at baseline, according to multivariate analysis.
4. Only PD tenosynovitis was discovered to be an independent predictor of RA and IA progression.
In conclusion, PD tenosynovitis may be utilized to predict the progression of RA and IA in individuals with CSA. A PD US scan might aid in the systematic evaluation of these patients, particularly those with elevated ESR and ACPA values.
Reference:
Molina Collada, J., López Gloria, K., Castrejón, I. et al. Ultrasound in clinically suspect arthralgia: the role of power Doppler to predict rheumatoid arthritis development. Arthritis Res Ther 23, 299 (2021). https://doi.org/10.1186/s13075-021-02685-7