Background Involvement of musculoskeletal system in Systemic lupus erythematosus (SLE) includes the presence of arthralgias, deforming arthritis, usually with a non-erosive (Jaccoud's) pattern and tenosynovitis. In a small percentage of patients there can be erosive features and synovitis indistinguishable from an inflammatory condition such as rheumatoid arthritis. Ultrasound technics offer the possibilities for detecting inflammatory changes even in an asymptomatic joints or periarticular tissues.
Objectives To compare the data obtained by Power Doppler ultrasound (PDUS) measurements of the wrists, small joints and tenosynovial compartments of the hands and feet with the clinical and laboratory data in patients with SLE.
Methods Fifthy-six SLE patients were included in the study. In all of them ultrasound examination on the wrists, small joints and tenosynovial compartments of the hands and feet including PDUS was performed. The patients were divided into two groups: group A (30 pts) presenting with arthralgias/arthritis and/or tenosynovitis and group B (26 pts) without musculoskeletal complains. Detection of inflammation included assessment of parameters as joint effusion (JE), synovial hypertrophy (SH) and grading the local pathological vascularization by PDUS on a semi-quantitative scale from 0 to 3. All patients underwent clinical examination, as well as laboratory measurements: erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), ANA, ENA, aPL, C3, C4. The disease activity was measured by SLEDAI -2K.
Results PDUS data suggesting inflammatory conditions were established in 83,33% of the patients with clinical apparent articular or periarticular involvement (group A) and in 19,23% of the asymptomatic patients (group B). There was low correlation between the PDUS data for arthritis/tenosynovitis and SLEDAI-2K. No correlation was found between PDUS findings and the immunological activity.
Conclusions Assessment of synovial inflammation including subclinical synovitis by PDUS parameters appears to be a promising sensitive method for detecting and monitoring the inflammatory activity in patients with SLE.
Disclosure of Interest None declared