Objectives: The aim of this study was to assess the value of power doppler ultrasound (PDUS) in combination with routine management in a very early inflammatory arthritis (IA) cohort.
Methods: 50 patients with ≤12 weeks of inflammatory symptoms +/- signs had clinical, laboratory and imaging assessments. Diagnosis was recorded at 12 months. Assuming a 15% pre-test probability of IA, post-test probabilities for various assessments were calculated and used to develop a diagnostic algorithm.
Results: All RF and/or CCP positive patients developed persistent IA so the added value of PDUS was assessed in the sero-negative (RF and CCP negative) group. The probability of IA in a sero-negative patient was 6%. The addition of clinical and radiographic features raised the probability of IA to 30% and with certain US features this rose to 94%.
Conclusions: In sero-negative early IA patients, combining PDUS with routine assessment can have a major impact on the certainty of diagnosis.