Doppler ultrasound and magnetic resonance imaging of synovial inflammation of the hand in rheumatoid arthritis: A comparative study

Terslev, Lene; Torp‐Pedersen, Søren; Savnik, Anette; Recke, Peter von der; Qvistgaard, Étienne; Danneskiold‐Samsøe, Bente; Bliddal, Henning

doi:10.1002/art.11245

Cited by 228 publications

(144 citation statements)

References 24 publications

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“…Most patients showed active ultrasound lesions at the wrists, whereas clinical symptoms were most frequently noted at PIP joints. In previous RA cohorts, a similar distribution of clinical and sonographic findings was reported (11). It can be assumed that the sonographic patterns of EORA and YORA patients are different, if large joints, particularly shoulders, are examined (8).…”

Section: Discussionsupporting

confidence: 66%

Elderly‐ versus younger‐onset rheumatoid arthritis: Higher levels of ultrasound‐detected inflammation despite comparable clinical disease activity

Dejaco

Duftner

Wipfler-Freißmuth

et al. 2013

Arthritis Care & Research

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Objective. To compare ultrasound-verified joint inflammation between elderly-onset rheumatoid arthritis (EORA) and younger-onset rheumatoid arthritis (YORA) patients. Methods. We conducted a retrospective analysis of 145 consecutive rheumatoid arthritis patients routinely assessed by sonography of wrists, metacarpophalangeal joints, and proximal interphalangeal joints, including semiquantitative scoring of synovial hypertrophy/effusion (SH/E) and power Doppler (PD) signals. Global ultrasound (GU) scores were calculated adding SH/E and PD results. EORA was defined by disease onset at age >60 years. Number of tender joints and swollen joints, global assessment of disease activity by physician or patient, Disease Activity Score in 28 joints (DAS28), Clinical Disease Activity Index (CDAI), and Simplified Disease Activity Index (SDAI) scores were recorded. Respective values for disease activity were accounted for in group comparisons using SPSS statistical software (version 18.0). Results. Seventy patients were diagnosed with EORA (mean

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Section: Discussionsupporting

confidence: 66%

Elderly‐ versus younger‐onset rheumatoid arthritis: Higher levels of ultrasound‐detected inflammation despite comparable clinical disease activity

Dejaco

Duftner

Wipfler-Freißmuth

et al. 2013

Arthritis Care & Research

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“…Quantitative approaches are also utilized, including the determination of the number of Doppler pixels by dedicated pixel-counting software 12,13,14,15 , measurement of pulsatility and resistive indices, and microbubble contrast material.…”

Section: Journal Of Rheumatologymentioning

confidence: 99%

A Systematic Literature Review Analysis of Ultrasound Joint Count and Scoring Systems to Assess Synovitis in Rheumatoid Arthritis According to the OMERACT Filter

Mandl

Naredo²,

Wakefield³

et al. 2011

J Rheumatol

186

110

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Objective. The OMERACT Ultrasound Task Force is currently developing a global synovitis score (GLOSS) with the objective of feasibly measuring global disease activity in patients with rheumatoid arthritis (RA). In order to determine the minimal number of joints to be included in such a scoring system, and to analyze the metric properties of proposed global (i.e., patient level) ultrasound (US) scoring systems of synovitis in RA, a systematic analysis of the literature was performed. Methods. A systematic literature search of Pubmecl and Embase was performed (January 1, 1984, to March 31, 2010). Original research reports written in English including RA, ultrasound, Doppler, and scoring systems were included. The design, subjects, methods, imaging protocols, and performance characteristics studied were analyzed, as well as the ultrasound definition of synovitis. Results. Of 3004 reports identified, 14 articles were included in the review. We found a lack of clear definition of synovitis as well as varying validity data with respect to the proposed scores. Scoring systems included a wide range and number of joints. All analyzed studies assessed construct validity and responsiveness by using clinical examination, laboratory findings, and other imaging modalities as comparators. Both construct validity and responsiveness varied according to the number and size of joints examined and according to the component of synovitis measured [i.e., gray-scale (GS) or power Doppler (PD) alone or in combination]. With regard to feasibility, time of evaluation varied from 15 to 60 min and increased with the number of joints involved in the examination. Conclusions. Ultrasound can be regarded as a valuable tool for globally examining the extent of synovitis in RA. However, it is presently difficult to determine a minimal number of joints to be included in a global ultrasound score. Further validation of proposed scores is needed. (J Rheumatol 2011; 38:2055-62; doi:10.3899/jrheum.110424

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“…There has been an increasing number of studies on the criterion and construct validity of US with CD or PD techniques for evaluating inflammatory activity in RA compared with evaluations of histologic features (9)(10)(11), magnetic resonance imaging results (12,13), clinical and laboratory parameters (4,14), and radiographic outcome (15,16).…”

Section: Conclusion These Findings Indicate That Pdus Is a Valid Metmentioning

confidence: 99%

Power doppler ultrasonographic monitoring of response to anti–tumor necrosis factor therapy in patients with rheumatoid arthritis

Naredo

Möller²,

Cruz

et al. 2008

Arthritis & Rheumatism

241

151

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Objective. To evaluate the validity, responsiveness, and predictive value of power Doppler ultrasonography (PDUS) monitoring of response to tumor necrosis factor (TNF) blocking agents in rheumatoid arthritis (RA).Methods. Three hundred sixty-seven RA patients were prospectively recruited at 25 Spanish centers; complete clinical, laboratory, and PDUS data were obtained on 278 patients. The patients underwent clinical, laboratory, and PDUS assessment at baseline and after 1, 3, 6, and 12 months of anti-TNF treatment, and radiographic assessment of the hands and feet at baseline and 12 months. The Disease Activity Score in 28 joints (DAS28) was recorded at each visit. PDUS examination included 86 intraarticular and periarticular sites in 28 joints. US synovial fluid (SF), synovial hypertrophy (SH), and PD signal were scored in all synovial sites. US count and index for SF, SH, and PD signal were obtained. Sensitivity to change of the PDUS variables was assessed by estimating the smallest detectable difference (SDD) from the intraobserver variability.Results. A significant parallel improvement in DAS28 and PDUS parameters was found at followup assessment (P < 0.0005 for within-subject between-visit changes). The SDD for PDUS parameters was lower than the mean changes throughout followup. Timeintegrated values of US joint count for PD signal and rheumatoid factor (RF) showed predictive value in relation to progression of radiographic erosion (R ‫؍‬ 0.64), and time-integrated values of US joint count for PD signal, RF, and erythrocyte sedimentation rate were predictors of progression of the total radiographic score (R ‫؍‬ 0.59).Conclusion. These findings indicate that PDUS is a valid method for monitoring response to anti-TNF therapy in RA; results obtained by PDUS are reproducible and sensitive to change. PDUS findings may have predictive value in relation to radiologic outcome.

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Doppler ultrasound and magnetic resonance imaging of synovial inflammation of the hand in rheumatoid arthritis: A comparative study

Cited by 228 publications

References 24 publications

Elderly‐ versus younger‐onset rheumatoid arthritis: Higher levels of ultrasound‐detected inflammation despite comparable clinical disease activity

Elderly‐ versus younger‐onset rheumatoid arthritis: Higher levels of ultrasound‐detected inflammation despite comparable clinical disease activity

A Systematic Literature Review Analysis of Ultrasound Joint Count and Scoring Systems to Assess Synovitis in Rheumatoid Arthritis According to the OMERACT Filter

Power doppler ultrasonographic monitoring of response to anti–tumor necrosis factor therapy in patients with rheumatoid arthritis

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