Background Although both systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) may lead to the joint deformity, lupus arthritis is typically non-erosive and often accompanied by Jaccoud's deformity. Therefore, we examined characteristics of joint and tendon lesions in treatment-naïve patients with SLE and RA by using ultrasonography.
Methods Thirteen treatment-naïve patients with SLE and 39 treatment-naïve RA patients with joint symptoms were included in this study. The hand joints and related tendons were ultrasonographically examined. Their joints and tendons including tendon sheaths were evaluated using a gray-scale (GS) and power Doppler (PD) to a semiquantitative method based on a scale of grades 0 to 3, and the joints or tendons graded as GS ≥2 or PD ≥1 were judged as having joint synovitis and or tendinitis/tenosynovitis.
Results Joint synovitis was observed in 11 of 13 (85%) and 37 of 39 (95%) patients with SLE and RA, respectively, while tendinitis/tenosynovitis were observed in 12 (92%) and 25 (64%) patients with SLE and RA, respectively. SLE patients had tendinitis/tenosynovitis in the wrist joints more frequently (77% versus 36%, p=0.023) as compared with RA. Although the joint synovitis score (GS+PD) per each affected joint was lower in SLE than RA (2.2 versus 2.8, p=0.019), the tendinitis/tenosynovitis showed comparable scores between SLE and RA (1.3 versus 1.0, p=0.446; Figure 1). In addition, the concordance of joint synovitis and tendinitis/tenosynovitis in the same region was less in SLE patients (κ=0.21) as compared with RA (κ=0.43).
Conclusions SLE arthropathy is characterized by the relative predominance of tenosynovitis as compared with RA. In addition, tenosynovitis in SLE may develop rather independently from joint synovitis.
Disclosure of Interest None declared
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