eprintid: 10067954
rev_number: 37
eprint_status: archive
userid: 608
dir: disk0/10/06/79/54
datestamp: 2019-02-19 11:23:31
lastmod: 2021-09-21 22:14:25
status_changed: 2019-06-05 09:15:03
type: article
metadata_visibility: show
creators_name: Ciurtin, C
creators_name: Jones, A
creators_name: Brown, G
creators_name: Sin, F
creators_name: Raine, C
creators_name: Manson, J
creators_name: Giles, I
title: Real benefits of ultrasound evaluation of hand and foot synovitis for better characterisation of the disease activity in rheumatoid arthritis
ispublished: inpress
subjects: UCH
divisions: UCL
divisions: B02
divisions: C10
divisions: D17
divisions: G90
keywords: musculoskeletal ultrasound; rheumatoid arthritis; Power Doppler
note: © The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/).
abstract: OBJECTIVE: Optimal management of rheumatoid arthritis (RA) depends on accurate evaluation of disease activity. Foot synovitis is not included in the most used RA outcome measure (DAS-28 score). The aim of this study was to investigate how ultrasound (MSK-US) examination of hand and feet correlate with DAS-28 score. We also explored whether performing MSK-US assessments of hands alone compared to hands and feet underestimates the disease activity in RA. METHODS: This is a real-life cross-sectional study of 101 patients (51 with RA and 50 with other musculoskeletal conditions) with inflammatory small joint pain, who underwent MSK-US examination of hands and feet. RESULTS: SK-US detected hand synovitis was found in 18/51 (35.3 %) RA patients and 16/50 (32%) of those with other musculoskeletal conditions (P=0.96), while foot synovitis was detected in 18/51 (35.3%) and 12/50 (24%) patients, respectively (P=0.78). DAS-28 did not correlate with any of the US outcome measures in patients with RA. Six out of 13 (46.1%) RA patients in remission, 7/14 (50%) with low disease activity and 18/32 (56.2%) with moderate disease activity (according to DAS-28 definition) had active synovitis as assessed by the MSK-US examination of their hands and feet. MSK-US detected synovitis led to treatment escalation in 26/51 (51%) RA patients. CONCLUSION: This study emphasises that MSK-US examination of hands and feet has led to optimised management of the majority of RA patients, which would have not been possible otherwise, because of the lack of correlation between DAS-28 assessment and MSK-US outcomes.
date: 2019-04-26
date_type: published
publisher: Springer Verlag
official_url: https://doi.org/10.1007/s00330-019-06187-8
oa_status: green
full_text_type: pub
language: eng
primo: open
primo_central: open_green
article_type_text: Journal Article
verified: verified_manual
elements_id: 1628458
doi: 10.1007/s00330-019-06187-8
language_elements: English
lyricists_name: Ciurtin, Coziana
lyricists_name: Giles, Ian
lyricists_name: Jones, Alexis
lyricists_name: Raine, Charles
lyricists_id: CCIUR23
lyricists_id: IGILE39
lyricists_id: ANJON28
lyricists_id: CRAIN11
actors_name: Novi, Maya
actors_id: MNOVI52
actors_role: owner
full_text_status: public
publication: European Radiology
issn: 0938-7994
citation:        Ciurtin, C;    Jones, A;    Brown, G;    Sin, F;    Raine, C;    Manson, J;    Giles, I;      (2019)    Real benefits of ultrasound evaluation of hand and foot synovitis for better characterisation of the disease activity in rheumatoid arthritis.                   European Radiology        10.1007/s00330-019-06187-8 <https://doi.org/10.1007/s00330-019-06187-8>.    (In press).    Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10067954/10/Ciurtin_Real%20benefits%20of%20ultrasound%20evaluation%20of%20hand%20and%20foot%20synovitis%20for%20better%20characterisation%20of%20the%20disease%20activity%20in%20rheumatoid%20arthritis_AOP.pdf