Ultrasound assessment of rheumatoid arthritis patients with clinically remission / 中华风湿病学杂志

ABSTRACT

Objective To discuss the value of high frequency ultrasound for the evaluation of subclinical rheumatoid arthritis.Methods Forty-four rheumatoid arthritis patientswho reached disease activity score (DAS28) clinical remis-sion were included.Ultrasound assess were carried out in all 68 joints,including bilateral temporomandibular joints,sternoclavicular joint,acromioclavicular joint,shoulder joint,elbow joint,wrist joint,1-5 metacarpophalangeal joints and the interphalangeal joint of the thumb,the 2-5 proximal interphalangeal joints,the 2-5 distal interphalangeal joints,hip,knee joint,ankle joint,tarsus joint,the 1-5 metatarsophalangeal joint,1-5 toeinterphalangeal joints.Analysis for the correlation between PD,GS score and gender,age,course of disease and clinical disease activity index were conducted.The pain visual analogue scale (VAS),time of morning stiffness,swollen joint count (SJC) and tender joint count (TJC),health assessment questionnaire (HAQ) score,erythrocyte sedimentation rate (ESR),and C-reactive protein (CRP) and rheumatoid factor (RF),anti cyclic citrullinated peptide (anti CCP) antibody,simplified disease activity index (SDAI),DAS28-CRP,DAS28-ESR were compared.Using Pearson and Spearman to analyze ultrasonic joint synovitis index score and clinical indexes,Student's t-test was employed to assess the significance of difference between two independent sample.Results Twenty-six patients reached/European League against Rheumatism (ACR/EULAR) 2011 remission,19 patients achieved ACR remission,and 3 patients achieved ultrasound remission.There was correlation between GS score and the course of disease and the number of swollen joints (r=0.602,0.470,P＜0.01).There was a positive correlation between ultrasound PD score and the patient's pain score,the total score of patients,ACR/EULAR2011,DAS28-ESR,DAS28-CRP (r=0.323,0.337,0.329,0.360,0.343,P＜0.05).The ultrasound PD score also had a positive correlation with CRP,ESR,time of morning stiffness (r=0.474,0.490,0.415,P＜0.01).Conclusion The subclinical arthrosynovitis can be detected by high frequency ultrasound in most rheumatoid arthritis patients at clinical remission.The PD ultrasound has advantage in evaluating RA activity over GS ultrasound.