Background Ultrasonography is widely used in the evaluation of joint lesions in rheumatoid arthritis (RA). While arthritis in systemic lupus erythematosus (SLE), unlike that in RA, is usually non-erosive and often accompanied by Jaccoud's deformity, ultrasonic characteristics of arthritis in SLE have scarcely been elucidated.
Objectives Therefore, we examined characteristics of joint and tendon lesions in SLE using ultrasonography.
Methods Fifty patients with SLE (45 female, the mean age of 47.5 years) treated in Toho University Ohashi Medical Center were subjected to ultrasonography on their wrists, metacarpophalangeal joints, (proximal) interphalangeal joints, and extensor/flexor tendons bilaterally. Their joints and tendons including tendon sheaths were evaluated using a gray-scale (GS) for synovial thickening and synovial fluid retention, and power Doppler (PD) for blood flow according to a semiquantitative method based on a scale of Grades 0 to 3, and patients graded with GS ≥2 or PD ≥1 were judged as having joint synovitis or tendinitis/tenosynovitis.
Results Thirty-two of the 50 patients (64%) were found to have relevant lesions, and joint synovitis was detected in 27 patients (54%). Tendinitis/tenosynovitis were detected in 24 patients, of whom 5 patients (21%) were found to suffer tendinitis/tenosynovitis without any synovitis. In addition, 14 of 24 patients (58%) had tendon lesions in a site free of joint synovitis. There was no significant relationship between other clinical or immunological features and US-detected articular findings.
Conclusions Our study using ultrasonography revealed that tendon lesions represent an important articular involvement in patients with SLE to the extent comparable to joint synovial lesions.
Disclosure of Interest None declared