Ab1128 sensitivity and Specificity of the Automated Squeeze Test (Gaenslen’s Maneuver) for Identifying Metacarpophalangeal Synovitis by Magnetic Resonance Imaging

Abstract

BackgroundIt is well known that an early diagnosis and treatment for Rheumatoid Arthritis (RA) prevents its complications, therefore there are many efforts to identify individuals at risk to develop RA. The Squeeze test has been used to detect synovitis in metacarpophalangeal joints, even though it is used in daily practice, there is a great variability in their performance among rheumatologists. [2]ObjectivesThe aim of this study is to determine the diagnostic performance of the automated squeeze test (AST) on the metacarpophalangeal (MCP) joints to detect the presence of synovitis, edema, or erosions by magnetic resonance imaging (MRI) using the rheumatoid arthritis magnetic resonance imaging score (RAMRIS) in first-degree relatives (FDR) of RA patients, of whom clinically suspect arthralgia (CSA) in hands was suspected, as well as in RA patients.MethodsIt is an observational and cross-sectional study for a diagnostic test. A total of 60 patients, older than 18 years, were included and divided in three groups: CSA group: 22 with less than 1 year with arthralgia and required to be FDR of RA patients; early RA group: 22 patients who met ACR/EULAR 2010 Classification Criteria with less than 1 year with the disease; and late RA group: 16 patients who met ACR/EULAR 2010 Classification Criteria, with more than 1 year with the disease. The AST was performed in the 60 participants’ dominant hand. The device was evaluated by MRI, which examined the same hand in the 60 patients.ResultsA total of 240 MCP joints were evaluated. The AUC for the total RAMRIS score >10 was [0.480 (95% CI 0.301-0.617) P=0.597], for synovitis RAMRIS score > 7 was [0.459 (95% CI 0.331-0.669) P=0.791], and for the presence of any synovitis by RAMRIS was [0.575 (95% CI 0.428-0.723) P=0.331]. For the RAMRIS synovitis score, the most sensitive and specific cut-off of the force by AST was 4.645 kg with a 66.7% sensitivity and 50% specificity.Abstract AB1128 Table 1 Baseline characteristics TOTAL CSA n=22 ERA n=22 LRA n=16 Age mean (SD) 44.7 (13.7)37.6 (10.9)49.05 (11.9)47.5 (16.2) Female n (%) 50 (83.3)18 (81.8)18 (81.8)14 (87.5) TJC median (IQR) 4 (12)0.5 (4)5 (13)10 (11) SJC median (IQR) 3 (8)0 (3)5 (12)7.5 (9) DAS28-ESR median (IQR) 4.8 (1.5)5.4 (1.4) HAQ median (IQR) 0.64 (0.75)1.47 (0.94) CDAI median (IQR) 18.07(16.8)23.8 (15.5) Married n (%) 41 (68.3)12 (54.5)15 (71.4)14 (93.3) Smoker n (%) 19 (31.7)2 (22.7)10 (45.5)4 (25) Morning stiffness n (%) 31 (51.7)4 (18.2)16 (72.7)11 (68.8) RF IgM positivity n (%) 46 (76.7)9 (40.9)12 (70.6)4 (25) ACPA positivity n (%) 25 (41.7)19 (86.4)20 (90.9)7 (43.8)Clinically suspect arthralgia, CSA; Early Rheumatoid Arthritis, ERA; Late Rheumatoid Arthritis, LRA; Tender Joint Count, TJC; Swollen Joint Count, SJC; Disease Activity Score – Erythrocyte Sedimentation Rate, DAS28-ESR; Health Activity Questionnaire, HAQ; Clinical Disease Activity Index, CDAI; Rheumatoid Factor, RF; Anti-citrullinated peptides antibodies, ACPA.ConclusionThe application of AST with a force of 4.645 kg, to exert pain in the dominant hand...

Ab1127 ultrasound Inter-Reader Reliability of Inflammatory Findings in Patients With Polyarthritis

“…The Squeeze test has been used to detect synovitis in metacarpophalangeal joints, even though it is used in daily practice, there is a great variability in their performance among rheumatologists. [2] Objectives: The aim of this study is to determine the diagnostic performance of the automated squeeze test (AST) on the metacarpophalangeal (MCP) joints to detect the presence of synovitis, edema, or erosions by magnetic resonance imaging (MRI) using the rheumatoid arthritis magnetic resonance imaging score (RAMRIS) in first-degree relatives (FDR) of RA patients, of whom clinically suspect arthralgia (CSA) in hands was suspected, as well as in RA patients. Methods: It is an observational and cross-sectional study for a diagnostic test.…”

“…Objectives: The aims of this study were to provide detailed description of the scanning protocol to measure the MT in the forearm and to test its feasibility and interobserver reliability. Methods: A total of 27 consecutive subjects were enrolled at Ospedale "Carlo Urbani", in Jesi (Ancona, Italy): 2 healthy volunteers recruited from among our staff, and 25 patients referred to the Rheumatology Department affected by rheumatoid arthritis (5), psoriatic arthritis (4), spondyloarthritis (3), polymyalgia rheumatica (2), systemic lupus erythematosus (1), systemic sclerosis (1), overlap SLE/SSc (1), Sjögren syndrome (1), antisynthetase syndrome (1), undifferentiated connective tissue disease (1), osteoporosis (1), small vessels vasculitides (2) and fibromyalgia (2). The female to male ratio was 19/27, the mean age was 52.1 years (SD ±13.7), and the mean Body Mass Index was 27.4 Kg/m² (SD ±4.2).…”