Background The ultrasonographic assessment of synovitis in rheumatoid arthritis (RA) is important for the establishment of appropriate treatment, development and monitoring of the patient. More useful and with the limited number of ultrasonographer and echograph of the authors are interested in finding reduced assessments of synovitis at hand.
Objectives – To compare ultrasonographic synovitis scores at the palmar and dorsal hands and wrists.
– To compare these scores with clinical parameters of disease activity.
Methods Cross-sectional study including 37 patients with RA meeting ACR 1987 collected in consultation. A predetermined questionnaire containing demographic, and laboratory data clinical was completed for all patients. Ultrasound examination was performed by a single experienced operator, with a 14 MHz linear probe. For each patient 20 joints were evaluated: radio-carpal, inter- carpal opposite ridge, metacarpo-phalangeal (MCP) 2-5, proximal inter phalange (PIP) 2-5 in dorsal and volar, making a total of 36 ratings. For each patient synovial hypertrophy (GSUS) was evaluated semi-quantitatively according to grades (0-3), the Doppler signal (PDUS) was measured semi quantitatively on a scale of 0 to 3.The ultrasound score for each patient is determined by the sum of the semi -quantitative scores GSUS and PDUs. The volar and dorsal ultrasound scores were obtained by adding the semi- quantitative grade of each face in each patient.
Results 37 patients were included with a mean age of 50.3±19.9 years. Disease duration of rheumatoid arthritis had a median of 7.5 years [3.2 to 19.2]; predominantly seronegative form on =26 (72.2%), the mean VAS overall patient was 42.7±. The mean HAQ was 1.6±0.6 and the mean DAS28 was 1.4±5 with a median of ultrasound score total =16 [8.5 to 29], dorsal ultrasound score had a median of 11 [6.5 to 20] and volar ultrasound score was 4 [1,5-8]. Correlation between dorsal ultrasound score and volar score was statistically significant p<0, 001 and a median dorsal row > the volar median rank. There is a statistically significant correlation between the patient ultrasound score (ES) and CDAI (r =0.343, p=0.03) between the ultrasound score dorsal (DES) and CDAI (r =0.335, p=0.04) and between the ultrasound score of the volar surface (VES) and CDAI (r =0.371, p=0.02), it was no significant correlation between the SDAI and all ultrasound scores (ES, DES, VES), correlation between ES and HAQ was statistically significant (r =0.475, p=0.003) and with the other two scores; ultrasound score was significantly correlated with the DAS 28 (r =0.045, p=0.03), correlation between doctor EVA and the 3scores was statistically significant but not significant between the 3 scores and VAS pain patient.
Conclusions In this study the correlation between dorsal and volar assessment of synovitis in rheumatoid arthritis and ultrasound parameters scores was similar
Disclosure of Interest None declared