FRI0562 Association between joint regions with ultrasound-determined synovitis and systemic inflammatory markers

Abstract

BackgroundIt is unknown which joint arthritis the inflammatory markers such as CRP or MMP-3 reflect.ObjectivesWe analysed the association between joint regions with ultrasound-determined synovitis and systemic inflammatory markers.MethodsWe enrolled 152 patients with untreated arthritis and performed musculoskeletal ultrasound on 40 joints and determined a semiquantitative grade for power Doppler (PD) signals. We analysed the associations between PD scores in 8 joint regions and CRP/MMP-3 levels using multiple linear regression models with forced entry method.ResultsMean age was 55 years and 112 patients were female. Median CRP and MMP-3 were 0.36 mg/dl and 65.7 ng/ml. Median total PD score was 2. Standard regression coefficients for 8 joint regions were −0.009 for MCPs, 0.05 for PIPs, 0.372 for wrists, 0.183 for elbows, 0.628 for shoulders, 0.377 for knees, 0.261 for ankles, and −0.0131 for MTPs in a regression model to explain CRP using PD scores as dependent variables. Standard regression coefficients for the same joint regions were −5.134,–4.449, 24.061, 27.839, 22.508, 64.108, 36.501, and 2.539 to explain MMP-3.ConclusionsSystemic inflammatory markers such as CRP and MMP-3 do not accurately reflect the inflammation in small joints. Conversely, it is necessary to weight the large joints for the global ultrasound synovitis score to represent the severity of systemic inflammation.References[1] Kawashiri SY, Kawakami A, Iwamoto N, et al. The power Doppler ultrasonography score from 24 synovial sites or 6 simplified synovial sites, including the metacarpophalangeal joints, reflects the clinical disease activity and level of serum biomarkers in patients with rheumatoid arthritis. Rheumatology (Oxford)2011May;50(5):962–5.[2] Gorai M, Ogasawara M, Matsuki Y, et al. Weighting with the Lansbury articular index improves the correlation of ultrasound score with serum matrix metalloproteinase-3 level in rheumatoid arthritis patients. Mod Rheumatol2014Nov;24(6):915–9.Disclosure of InterestNone declared