The objective of the present study was to evaluate whether an innovative quantitative ultrasound (QUS) technique, Radiofrequency Echographic Multi Spectromety, which combines B-mode ultrasound and radiofrequency signals, is reliable in typical Romanian patients compared to previous results obtained using dual-energy X-ray absorptiometry (DXA). The study prospectively included previously unscreened post-menopausal females with rheumatoid arthritis (RA) and age-matched healthy controls. Bone mineral density (BMD) measurements were performed with an EchoS machine (Echolight ® ), which combines B-mode ultrasound and radiofrequency signals. The study included 106 RA patients, with a median disease duration of 3.2 (0.5–22) years and 119 controls. RA patients had a significantly lower body weight, body mass index (BMI) and basal metabolic rate (BMR) than the controls, while the prevalence of obesity and body fat differed insignificantly. RA patients had a significantly lower spine and hip BMD, higher fracture risk and higher prevalence of osteoporosis. Compared to RA patients without osteoporosis, those with osteoporosis were significantly older and had a longer menopause duration, but they had a significantly lower BMI, body fat, BMR and prevalence of obesity. Among the controls and RA patients, the median spine and hip BMD became significantly higher as the BMI increased from underweight to obesity. In conclusion, osteoporosis is prevalent among RA patients, as a part of a complex transformation of body mass composition, involving BMI and fat mass. The novel QUS scanning technique was able to replicate the results of the established DXA measurement of BMD and is potentially suitable for screening wide populations for osteoporosis.

Background. The musculoskeletal system is deeply involved in patients with CKD on dialysis. The studies that were done by now with regarding this subject mostly aimed the bone metabolism.So far, there is few data on the subject concerning the articular and abarticular abnormalities in dialysed patients(1). Objectives. To indentify the musculoskeletal soft tissue abnormities associated to dialysis and to evaluate whether or not they are more frequent. Also, we set ourselves to point out the importance of detecting these anomalies early in the evolution, in order to preserve the joint function and the quality of life, in a category of patients already severely affected. Materials and methods. This is a prospective study, ran on a period of 4 months. We included 55 patients ( 32 in the study group – on dialysis, 23 in the control group – late stage pre-dialysis chronic kidney disease). For each patient, we evaluated 68 joints using ultrasonography. Also, a visual analogue scale for pain was applied for each patient. Results. The findings vary from median nerve entrapment and tendon calcifications, to usual degenerative abnormalities, synovitis and tenosynovitis. The type of abnormalities does not vary between the two groups, but the percent of the affected patients was much higher in the study group. Conclusions. A great number of patients from the study group presented important articular and mostly abarticular abnormalities, sometimes with no correlation with the algofunctional symptoms.

BackgroundThere is a great need of a screening programme for osteoporosis in the general population and even more amongst the rheumatologic patients, with additional risk factors. Although DXA is the gold standard for diagnosing osteoporosis, it is not appropriate for screening, because of its’ limitations regarding ionising radiation, but also the massive machine, that needs dedicated spaces and specialised operators, all in all, involving high costs.ObjectivesTo apply a new method that integrates ultrasonography with radiofrequency signals from an echographic scan, in order to evaluate the bone mineral density (BMD) and T-scores in patients with rheumatoid arthritis (RA), compared to a control group.MethodsWe enrolled 150 menopausal women, 75 diagnosed with RA and 75 age matched controls. The controls were selected considering the lack of both an inflammatory disease and history of corticotherapy.All patients in the study group were under monotherapy with a conventional synthetic DMARD and they are or have been under corticotherapy during the evolution of RA.The BMD and T score were evaluated using a quantitative ultrasound Echolight machine. There were two evaluators for both lots, on order to minimise the inter-observer variability.ResultsAbstract AB1214 – Table 1Study groupControl group Age distribution (years)63,2449 – 8564,1941 – 85Menopause age (years)46,9 (34–60)45,7830 – 55BMI (kg/m2)25.97 (15.63–34.86)26.83 (18.36–33.67)Period since dg of RA (years)7.26 (5–12.5)–13% of the patients in the study group were under corticotherapy at the moment they were recruited in the study and 87% were treated with cortisone before, at some point during the evolution of RA. The average dose followed for more than 2 weeks was 8.8 (5–15) mg prednisone/day. The average corticotherapy period of 2.6 (0.5–14) months.For the lumbar vertebrae (L1-L4), the average T score in the study group was −1.81, while the control group had a T score of −1.11. For the femoral neck, the average T score for both hips was −1.73 for the study group and −1.04 for the controls.The spine average BMD was 0.92 g/cm2 in the study group, compared to 1.16 g/cm2 in the control group. For the femoral neck, the study group average BMD was 0.72 g/cm2, while in the control group it was 0.94 g/cm2.ConclusionsThe differences between the two groups were significant, but still in the osteopenia interval. The significance of these results translates into an increased fracture risk and a longer treatment duration in the study group.At this point, this is a preliminary study, but we plan to continue it by comparing these results to DXA results for the same patients, in order to evaluate the cost-effective superiority of this portable, radiation-free technique, in a screening programme.References[1] Casciaro S, Peccarisi M, Pisani P, et al. An Advanced Quantitative Echosound Methodology for Femoral Neck Densitometry. Ultrasound Med Biol2016; 42(6):1337–1356.[2] Aventaggiato M, Conversano F, Pisani P, et al. Validation of an automatic segmentation method to detect ve...

BackgroundThere are numerous studies about the musculoskeletal abnormities associated with dialysis, but most of them target osteoporosis and the bone metabolism. While this is, in fact, of great importance, we consider that the abarticular anomalies should also be taken into account. Because of the pain they cause and the quality of life impairment in patients already affected in this domain, suffering from depression or at its’ edge.ObjectivesWe aimed to detect the dialysis associated soft tissue abnormalities, using musculoskeletal ultrasound(MSUS) scanning of patients diagnosed with late-stage chronic kidney disease(CKD) on dialysis. In order to achieve this, we compared the data obtained from this group, to a control group of pre-dialysis late-stage CKD.MethodsOver the last 8 months, we ran a prospective study including 102 patients. The study group included 52 patients with stage G5D (GFR <15 ml/min/1.73 m2, on dialysis – hemodialysis (HD)/peritoneal dialysis (PD)), while the control group included 50 patients with stage G5 (GFR <15 ml/min/1.73 m2, pre-dialysis). Each patient had 68 joints scanned with a Samsung HM70A machine, by the same ultrasonographist, in order to avoid the inter-observer variability. Also, each patient completed a visual analogue scale (VAS) for evaluating pain.Sex study group: M: 30 (57.69%) F: 22 (42.3%)Sex control group: M: 28 (56%) F: 22 (44%)Age (years) study group: 62,5230 – 82 Age (years) control group:64,1 (33–84)HD/PD study group: HD: 46 (88.46%) DP: 6 (11.53%)Time on dialysis (years) study group: 6,41 (0,5–22)ResultsThe findings included median nerve entrapment (71.1% – study group, 18% – control group), tendon calcifications (61.5% – study group, 38% – control group), degenerative abnormalities (57.6% – study group, 50% – control group), synovitis (32.6% – study group, 22% – control group) and tenosynovitis (13.4% – study group, 8% – control group). There were no particular abnormalities found only in the study group, but the percentages of the common findings were significantly higher.The VAS results were split in three groups: low, moderate and high. Among the patients on dialysis, 46.1% declared a low VAS, 36.5% moderate and 17.3% a high VAS, while in the control group the distribution according to VAS was 46% in the low lot, 34% in the moderate and 20% in the high lot.ConclusionsWe detected soft tissue abnormalities in an important percentage of patients on dialysis, but the results were disproportionate to the algo-functional symptoms. We found a higher percentage of low VAS then we were expecting.Considering the results, we plan to continue our study, aiming to create a rehabilitation programme adapted to the needs of the dialysed patient.References[1] Gheita TA, Sayed S, Al-ghitany A, et al. Musculoskeletal Manifestations in Renal Hemodialysis Patiens. Ann Rheum Dis2016; 75(2):1260.[2] Yamazaki T, Kawahara N, Arai K, et al. Utility of Ultrasonography of the Median Nerve With a High-Frequency Probe for the Diagnosiis of Dialysis-Related Carpal Tunnel Syndrome, Ther Aph...