Background DAS28 based treat-to-target (T2T) strategy¹ was shown to improve outcomes in patients with rheumatoid arthritis (RA). Although previous studies have shown that approximately 1/3 of RA patients have foot symptoms[,² ankle and foot joints are not included in DAS28.

Objectives To study the prevalence of ankle synovitis in clinically and serologically different forms of RA, treated according to the updated T2T strategy.

Methods 1109 patients, with RA, treated according to the T2T approach were included in this study. Concurrent tenderness and swelling of the ankle joint were considered as synovitis. Rheumatoid factor (RF) and anti-mutated citrullinated vimentin (anti-MCV) positive and negative patients with different disease activity were evaluated.

Results 8.47% (94) patients had high (DAS28 >5.1); 35.25% (391) moderate (DAS28 ≤5.1;>3.2) and 18.66% (207) low (DAS28 ≤3.2;≥2.6) disease activity. 37,6% (417) of patients were in clinical remission (DAS28 <2.6). 60.71%¹⁷ of anti-MCV and RF positive and 44.8%¹³ of anti-MCV and RF negative patients with high disease activity had ankle synovitis (table 1). Regarding patients in remission, 13.7%¹⁸ of anti-MCV and RF positive and 15%¹⁸ of anti-MCV and RF negative patients had ankle synovitis (table 2). Interestingly, ankle synovitis was considerably more common than knee synovitis in all patient groups.

Conclusions Our present data show that ankle synovitis is rather common in patients with serologically and clinically different forms of RA and highlight the importance of careful medical examination, even in case of clinical remission.

References [1] Smolen JS, et al. Ann Rheum Dis. 2016Jan;75(1):3–15.

[2] Dixey J, et al. J Rheumatol2004;69:48–54.

Disclosure of Interest None declared