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AB0717 Effect of mechanical stress into the ultrasonographic assessment of healthy subjects: the monday’s synovitis
  1. C. A. Guillen Astete1,
  2. C. Sobrino Grande1,
  3. M. Ahijón Lana1,
  4. A. Zea Mendoza1
  1. 1Rheumatology, Ramon y Cajal Universitary Hospital, Madrid, Spain

Abstract

Background Musculoskeletal ultrasonography (MUS) is been considered as a useful tool for the study of patients with inflammatory rheumatic diseases due to its capacity to detect subclinic synovitis. Because of that, it is imperative to exclude other causes of synovitis that could be present in healthy people as well. In our experience, physical overexertion is performed by people, most frequently on weekends. According to that, it seems reasonable to assume that an ultrasonographic assessment performed after a weekend could detect not only synovitis related to a chronic inflammatory rheumatic disease but also acute changes related to overexertion, however, as far as we know, there is no study that demonstrated the effect of overexertion among ultrasonography findings in joints of healthy people.

Objectives The aim of present study is to compare the proportion of synovitis detected by MUS in healthy subjects according to their self evaluation of exertion level the day before.

Methods Four hundred and seven consecutive volunteers were enrolled in a 12 month period. A MUS of carpal, second and third metacarpophalangeal joints were performed in both hands. All studies took place in Monday or Friday. Subjects were grouped according self evaluation of level of exertion the day before (usual activity or overexertion). Presence or absence of synovitis were compared between both groups and according to the hand studied (dominant or not). Every MUS were performed with a 10-13 MHz linear probe.

Results 4.2% of subjects studied on Fridays and 30.2% of subjects studied on Monday reported an overexertion the day before (p<0.001, contingency coefficient 0.331). In the dominant hand proportions of synovial hypertrophy, synovial effusion and power Doppler signal were 29.6, 12.6 and 9.1% respectively in patients who reported overexertion and 11.1, 5.4 and 3.9% respectively in patients who reported usual activity (p<0.05 in all comparisons). Those differences were not observed when comparisons of the not dominant hand were performed. Presence of any finding related to synovitis (synovial effusion or hypertrophy) was statistically higher in subjects studied on Mondays compared to Fridays (34.9 and 12.1%, respectively) and in subjects who informed an overexertion the day before compared to subjects who did not (47.7 and 11.5%, respectively).

Conclusions After a physical overexertion, the probability of detection of synovitis is higher compared to subjects who performed usual activities. In general, we recommend performing MUS after usual activity in order to minimize the chance of detecting synovitis related to overexertion. Also, whenever is possible, is recommendable to chose non dominant joints (research, non symptomatic people) when the MUS is performed close to a recent overexertion.

Disclosure of Interest None Declared

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