Background early diagnosis of rheumatoid arthritis (RA) is difficult as no single clinical manifestation, laboratory test, or imaging study results allow a diagnosis of RA to be made with certainty.
Objectives to detect the practical usefulness of ultrasonography (US), Doppler ultrasonography (PDUS), magnetic resonance imaging (MRI) and anti-CCP antibody testing as predictors of diagnosis and outcome of rheumatoid arthritis in patients with early inflammatory arthritis.
Methods sixty individuals were included in this study, forty patients with inflammatory arthritis and twenty apparently healthy subjects served as controls. All patients were subjected to full history taking & thorough clinical examination then assess the DAS28.laboratory investigations were done in the form ofESR, CRP, Anti-cyclic citrullinated peptide 2 (anti-CCP2) antibodies and radiological investigations in the form of US and PDUS 40 jointssearching for evidences of synovitis and erosions. MRI of both wrists and hands; all patients were followed up for at least 12 months; at this point patients were diagnosed according to both the 1987 revised ACR and The 2010 ACR/EULAR classification criteria for rheumatoid arthritis. In order to detect the severity of the disease, the Rheumatoid Arthritis Severity Scale (RASS) was assessed.
Results After one year, 50% of our patients fulfill ACR 1988 criteria of classification of RA while 62.5% fulfill 2010 RA ACR/EULAR classification criteria. There was a significant correlation between the UStotal score of synovitis, PDUS total score of synovitis,synovitis and bone marrow edema detected by MRI at base line and diagnosis of RA by either ACR 1988 or ACR 2010 criteria one year later.There was a significant correlation between the level of anti-CCP2 at base line and diagnosis of RA by ACR/EULAR 2010, one year later.There was a significant correlation (p≤0.01) between RASS in patients diagnosed as RA according to ACR/EULAR 2010 criteria and each of the level of AntiCCP2 and the US total score of synovitis bone marrow edema detected by MRI at base line. However, there was a non-significant correlation between RASS and synovitis detected by either PDUS or MRI.
Conclusions AntiCCP2, MSUS, PDUS and MRI are useful predictors for the diagnosis of rheumatoid arthritis in patients with early inflammatory arthritis. PDUS at base line does not correlate with severity of RA one year later
Disclosure of Interest None Declared