Comparison of Prevalence of Synovitis by Ultrasound Assessment in Subjects Exposed or Not to Self-Reported Physical Overexertion: The Monday’s Synovitis

Abstract

Objective. To compare the proportion of synovitis detected by ultrasonographic study (USS) of the hands, in subjects with no rheumatologic known disease according to self-reported level of overexertion performed the day before. Methods. 407 consecutive volunteers were enrolled in a twelve-month period and underwent an ultrasound assessment of the hand. All studies were performed on Monday or Friday. Subjects were grouped according to their self-reported overexertion carried out the day before. Presence or absence of ultrasonographic findings compatible with synovitis was compared between groups. Results. 95.8% of those tested on Friday had made no overexertion the day before the study, while 30.2% of those assessed on Monday declared to have carried out an overexertion. Presence of carpal synovial hypertrophy, synovial fluid/effusion, and power-Doppler signal was statistically higher in subjects who carried out an overexertion the day before the study than the rest of subjects when the dominant hand was assessed. Globally, presence of any synovitis ultrasonographic finding was statistically higher in subjects who were studied on Monday than Friday (34.9% versus 12.1%) and in subjects who self-reported an overexertion the day before compared to the rest of subjects (47.7 versus 11.5%). Conclusions. In general, we recommend performing the USS as many days as possible after the most recent overexertion.

Prevalence of subclinical synovitis of the hand in patients with systemic lupus erythematosus

“…15 On the other hand, we have considered the prevalence of synovitis in healthy subjects recently described (11.5–12.1%). 23 For a 95% confidence level, an accuracy of 5% and assuming a similar scenario that was found by Yoon et al., the sample size calculated was 76 individuals. Assuming the pessimistic scenario based on the results of Demirkaya et al., the sample size would be 90.…”

“…In this regard, previous studies have suggested that grade I synovitis should not necessarily be considered pathological since it can be identified in healthy subjects or induced after physical activity and disappear after rest. 23,32 Reporting synovitis prevalence studies using composite indices is probably most appropriate for comparison between studies.…”

“…As control group, we used data from a previous study conducted to determine the prevalence of hand synovitis in subjects before and after overexertion. 23 Those subjects were paired with the sex and age (+/− 3 years old) of the corresponding patients. Those controls were medical students, medical residents and other workers of Ramon y Cajal University Hospital and relatives of non-immune mediated rheumatic disease patients.…”

Ultraschall peripherer Gelenke und des Achsenskeletts

“…Die Grenzen des Normalen zum Pathologischen sind nicht nur fließend sondern zudem von äußeren Einflußfaktoren abhängig. In einer Studie wurden signifikant häufiger synoviale Hypertrophie, Erguss und/oder Power-Doppler-Aktivität bei Patienten gefunden, die sich am Tag vor der Untersuchung körperlich überanstrengt hatten im Vergleich zu Patienten, die diese Anstrengung nicht angaben, weshalb dazu geraten wird eine US-Untersuchung so viele Tage wie möglich nach einer solchen Anstrengung durchzuführen [10].…”

Hand dominance in early and established rheumatoid arthritis: evaluation by dynamometer, Ritchie index and musculoskeletal ultrasound: a cross sectional study

“…Several previous studies have addressed the effect of handedness on RA progression. Most of them compared both hands in terms of radiological score, hand deformity, handgrip strength and Ritchie articular index (RAI) (3)(4)(5). These studies concluded that hand dominance has an impact on the disease course, and hypothesized that mechanical stress increase the disease plateau (3,4), which is mainly seen in early RA (5,6).…”