Table 1

Ultrasound and remission: the evidence base

AuthorYearNumber of patientsTreatmentDefinition of clinical remission for inclusion into studyJoints scannedDefinition of ‘imaging remission’Time to scan
Brown et al 152006107, late DD median 7 years238DMARDAs defined by treating rheumatologistFive joints; dominant wrist and MCPJ2–5Used a semiquantitative score; did not define imaging remission30 Min
Wakefield et al 36200710, early DD median 6 m (3–11 months)Anti-TNFDAS28 <2.6; NB: patients had active disease at inclusion42 Joints: shoulders, elbows, wrists, MCPJ, PIPJ, knees, ankles, MTPJSemiquantitative score for GS and PD; remission defined as absence of GS and PD50 Min
Saleem et al 162009100, late DD; median 120 months (72–183)50 DMARD, 50 anti-TNFDAS28<2.6Five joints: dominant wrist and MCPJ2–5Semiquantitative score for GS and PD; remission defined as absence of GS and PD30 Min
Balsa et al 37201097, late (mean DD 5.9 years)DMARD, biologicAs defined by treating rheumatologist42 Joints: shoulders, elbows, wrists, MCPJ, PIPJ, knees, ankles, TNJ and MTPJSemiquantitative for GS and PD; remission defined as an absence of joints with a PD signal45 Min (including documentation)
Scirè et al 382009106, earlyDMARDDAS<1.644 Joints: shoulders, elbows, wrists, MCPJ, PIPJ, SCJ, ACJ, knee, ankle and MTPSemiquantitative score for PD and GS; did not define imaging remission; calculated a summative score60 Min
Peluso et al 39201194 (48 early: 6.9 months±3) and 46 late: 118.9 months±71.7)Early: DMARD±anti %) Late: All DMARD±anti-TNFDAS<1.610 Joints (12 joint areas): bilateral MCPJ 2–3, PIPJ 2–3, wrist (two regions)Used 3 definitions: active synovitis (SH and PD), US remission: no SH or PD; inactive synovitis: SH but no PDNot documented
Saleem et al 40201047 (27 early: DD 19 months, 20 late: DD 120 months)All DMARD and anti-TNFDAS28<2.6Five joints: dominant wrist and MCPJ2–5Semiquantitative score for GS and PD; remission defined as absence of GS and PD30 Min
Saleem et al 482011128, late; DD 8 years (5–13 years)DMARD and TNF blockerDAS28<2.6Five joints; dominant wrist and MCPJ2–5Semiquantitative score; imaging remission – 1. no GS or PD; 2. low disease activity (GS≤1) and PD=0; 3. PD=0; 4. PD≤130 Min
  • DAS, disease activity score; DMARD, disease modifying antirheumatic drugs; GS, grey scale; MCPJ, metacarpophalangeal joint; PD, power Doppler; TNF, tumour necrosis factor; US, ultrasound, DD, disease duration; PIPJ, proximal inter-phalangeal joint; TNJ, talo-navicular joint; ACJ, acromio-clavicular joint; MTP, metatarsophalangeal joint; SH, synovial hypertrophy; NB, Nota Bene, note.