AB0643 Ultrasounography assessment of non-deforming lupus arthropathy

Abstract

Background Lupus arthropathy has different compromise levels, not always progressive, that includes asymptomatic forms, deforming, erosive or even resorptive arthropathy. Until now, the ultrasonography (US) is useful to assess inflammatory status in patients with chronic or episodic arthritis. Recent studies have shown that inflammatory activity is demonstrable by US in other types of arthropathy. Objectives To perform an US assessment of non-deforming forms of SLE arthropathy and its relationship with other clinical findings. Methods 76 medical records of SLE patients without deforming arthropathy were revised. Epidemiological, clinical and laboratory data were collected. A complementary medical interview were performed to all patients in order to review clinical and historical data. US protocol applied to all patients included both carpal joint (dorsal and ventral), 2nd and 3rd metacarpophalangeal (MCP) of both hands, 2nd and 3rd flexor tendons of both hands at its passage through the MCP joints. US studies were perform to assess the existence or absence of synovitis, effusion, tendinosis and power doppler signal (PDS). For the statistical analysis, x2 and T student tests were used where appropriate. Results We identified three groups of joint involvement according to clinical data: (1) Asymptomatic patients n=15, (2) patients with intermittent or continuous arthralgias n=40, and (3) patients with arthritis n=21. Times of disease from diagnosis were different in the three groups. A 66,67% of patients from group 1 was diagnosed with 3 or more analytical criteria and 33,3% with 3 or more clinical criteria. The inverse proportion was found in group 2 and 3. All those comparissons were statistically significant. The clinical response to NSAID, hydroxycloroquine, metotrexate and glucocorticoids were similar among the groups. Synovial effusion and PDS were present in 33 and 40% respectively in group 1. Synovial effusion was present in 15% and 61,9% of group 2 and 3 respectively. Conclusions (1) We have demonstrated ecographic inflammatory activity in SLE patients that in our cohort reaches 40% of the asymptomatic patients. These results widely surpass other series results probably because we have considered positive any PDS level of intensity and not only the clinically significant. (2) In patients without clinical arthritis, there is enough ecographic evidence of it in more than one third of patients. (3) There is an association between SLE diagnoses based in clinical criteria with inflammatory, clinical and ecographic joints manifestations. Disclosure of Interest None Declared