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Power Doppler ultrasonography (PDUS) is a valid technique to detect, quantify and monitor synovial vascularisation in chronic inflammatory arthropathies.1,–,5 Despite this, its reliability is a major issue, and a consistent body of evidence emphasising the influence of several factors in PDUS variability has been published in the last few years.6,–,9 Thus, the minimisation of all potential sources of variability emerges as a crucial need.
Since in rheumatoid arthritis (RA) joint stiffness and pain show a clear circadian variation,10 we aimed at determining whether the PDUS signal of metacarpophalangeal (MCP) joints might vary according to the time of day in RA patients.
A total of 10 RA patients with active disease (DAS28 >3.2) despite disease-modifying antirheumatic drugs or biological treatment, recruited from the two rheumatology departments involved, underwent three PDUS examinations of MCP joints, during the same day, at three different times: T0, between 7:00 and 10:00; T1, 4–6 …
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