Correlation and agreement between physical and ultrasound examination after a training session dedicated to the standardization of synovitis assessment in rheumatoid arthritis patients

Quintana-López, Gerardo; Maldonado-Cañón, Kevin; Flórez-Suárez, Jorge Bruce; Méndez-Patarroyo, Paul; Coral-Alvarado, Paola; Calvo, Enrique

doi:10.1186/s42358-021-00227-y

Cited by 3 publications

(1 citation statement)

References 23 publications

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“…The discrepancy observed between clinical assessments and US findings can be attributed to several factors, including the coexistence of osteoarthritis, pre-existing joint abnormalities, and the subjective nature of clinical evaluation thresholds. This discrepancy highlights the inherent limitations of relying solely on physical examination findings to diagnose synovitis in RA patients (8,19).…”

Section: Discussionmentioning

confidence: 99%

The Concordance of Patient-Reported Symptoms, Physical Examination and Ultrasound-Detected Synovitis, in Active Rheumatoid Arthritis

Naz,

Rasheed,

Ilyas

et al. 2024

JHRR

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Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by joint synovitis and systemic inflammation, with joint swelling and tenderness as common clinical manifestations. Accurate assessment of disease activity is crucial for effective management and treatment planning. While ultrasound (US) has emerged as a sensitive tool for detecting synovitis, its concordance with clinical examination findings remains a subject of ongoing research. Objective: The objective of this study was to evaluate the concordance between clinical examination findings and ultrasound-detected synovitis in RA patients, with an emphasis on the diagnostic value of joint swelling and tenderness. Methods: This observational, cross-sectional study involved 40 RA patients with moderate to severe disease activity, assessed at a single center. Following ethical approval and informed consent, patients were evaluated for joint swelling, tenderness, and patient-reported symptoms. Ultrasound examinations were conducted to detect synovitis, employing gray scale (GS) and power Doppler (PD) modalities. Concordance between clinical findings and US-detected synovitis was analyzed using Cohen's kappa statistic. Disease activity was categorized using the DAS28 score, with subgroup analyses across different disease activity states. Results: Joint swelling demonstrated the highest concordance with US-detected synovitis (kappa = 0.44), while joint tenderness showed lower concordance (kappa = 0.23). Analysis across disease activity states revealed consistent concordance for joint swelling (kappa values ranging from 0.38 to 0.41), regardless of disease severity. Patient-reported symptoms and the use of specific treatments (methotrexate and biologics) were also analyzed, with 90% of patients on methotrexate and 10% on biologics. The study population was predominantly female (86%) and middle-aged (20 to 40 years: 66%). Conclusion: Our findings indicate that joint swelling is a more reliable clinical indicator of synovitis in RA patients compared to joint tenderness. This suggests that disease activity scoring systems in RA might benefit from placing greater emphasis on swelling and patient-reported symptoms. Future research should explore the integration of these parameters to enhance the accuracy and efficiency of RA management.

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Section: Discussionmentioning

confidence: 99%

The Concordance of Patient-Reported Symptoms, Physical Examination and Ultrasound-Detected Synovitis, in Active Rheumatoid Arthritis

Naz,

Rasheed,

Ilyas

et al. 2024

JHRR

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Antioxidant activity and characteristics of a cocoa drink formulated with encapsulated green coffee extract

Indiarto

Rahimah

Subroto

et al. 2022

International Journal of Food Properties

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Practical Use of Ultrasound in Modern Rheumatology—From A to Z

Sapundzhieva,

Sapundzhiev,

Batalov

2024

Life

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During the past 20 years, the use of ultrasound (US) in rheumatology has increased tremendously, and has become a valuable tool in rheumatologists’ hands, not only for assessment of musculoskeletal structures like joints and peri-articular tissues, but also for evaluation of nerves, vessels, lungs, and skin, as well as for increasing the accuracy in a number of US-guided aspirations and injections. The US is currently used as the imaging method of choice for establishing an early diagnosis, assessing disease activity, monitoring treatment efficacy, and assessing the remission state of inflammatory joint diseases. It is also used as a complementary tool for the assessment of patients with degenerative joint diseases like osteoarthritis, and in the detection of crystal deposits for establishing the diagnosis of metabolic arthropathies (gout, calcium pyrophosphate deposition disease). The US has an added value in the diagnostic process of polymyalgia rheumatica and giant-cell arteritis, and is currently included in the classification criteria. A novel use of US in the assessment of the skin and lung involvement in connective tissue diseases has the potential to replace more expensive and risky imaging modalities. This narrative review will take a close look at the most recent evidence-based data regarding the use of US in the big spectrum of rheumatic diseases.

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Correlation and agreement between physical and ultrasound examination after a training session dedicated to the standardization of synovitis assessment in rheumatoid arthritis patients

Cited by 3 publications

References 23 publications

The Concordance of Patient-Reported Symptoms, Physical Examination and Ultrasound-Detected Synovitis, in Active Rheumatoid Arthritis

The Concordance of Patient-Reported Symptoms, Physical Examination and Ultrasound-Detected Synovitis, in Active Rheumatoid Arthritis

Antioxidant activity and characteristics of a cocoa drink formulated with encapsulated green coffee extract

Practical Use of Ultrasound in Modern Rheumatology—From A to Z

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