Hip Joint Ultrasonography: Correlation With Intra-Articular Effusion and Synovitis

Koski, Juhani M.; Anttila, P; Hämäläinen, Martti; Isomäki, H

doi:10.1093/rheumatology/29.3.189

Cited by 51 publications

(19 citation statements)

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“…Joint effusion or synovitis distends the capsule outwards and the anechogenic distance between bone and capsule lengthens. 17 The following criteria were used to assess the eligibility of study participants: patients with complete ankylosis of the spine; patients with unilateral or bilateral synovial hyperplasia, and/or effusions of the hip assessed by ultrasonography; patients without previous history of tuberculosis, hepatitis, and other infection diseases; patients in agreement with etanercept treatment. In patients with bilateral synovitis of the hip, we mainly focused on the more severely affected side.…”

Section: Introductionmentioning

confidence: 99%

Dose reduction of recombinant human tumor necrosis factor inhibitors (etanercept) can be effective in ankylosing spondylitis patients with synovitis of the hip in a Chinese population

Wang

Han

et al. 2016

Int J Immunopathol Pharmacol

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Ankylosing spondylitis (AS) is an immune-mediated inflammatory arthritis and enthesitis involving the spine and peripheral joints. In recent years, specific antagonist of tumor necrosis factor (anti-TNFα, etanercept) 50 mg weekly therapy has rapidly gained popularity for the treatment of AS. However, the dose of etanercept has not been determined in Asian, particularly Chinese populations. The purpose of the study was to evaluate the efficacy and safety of dose reduction of etanercept (50 mg/week in 4 weeks followed by 25 mg/week in 8 weeks) in the treatment of AS with synovitis of the hip, as against the conventional dose (50 mg/week in 12 weeks) in a Chinese population. Forty-three Chinese AS patients with synovitis of the hip were involved in this study. Seventeen of them were randomized to receive conventional dose of etanercept treatment and 26 were given a dose reduction regimen for 12 weeks. The primary efficacy endpoint was disease activity of response for AS at week 12, including Bath AS Disease Activity Index (BASDAI), the serum erythrocyte sediment rate (ESR), C-reactive protein (CRP), and assessment of synovitis of the hip by ultrasonography. At 12 weeks, all of the patients had responses to some extent and the efficacy variables improved significantly over time, but not between treatment groups. Nine patients experienced at least one adverse event (generally, infections and injection site reactions), most of them mild or moderate. In sum, the dose reduction of etanercept regimen in the 12-week AS treatment was confirmed as a safe and effective therapy as the conventional dose was given.

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Section: Introductionmentioning

confidence: 99%

Dose reduction of recombinant human tumor necrosis factor inhibitors (etanercept) can be effective in ankylosing spondylitis patients with synovitis of the hip in a Chinese population

Wang

Han

et al. 2016

Int J Immunopathol Pharmacol

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“…6 Several studies have demonstrated that high frequency US is accurate for detecting joint effusion [7][8][9][10][11][12][13][14][15][16] and synovitis, 7-11 15 17-19 , compared with magnetic resonance imaging (MRI) 10 12 14 17 and direct arthroscopic visualisation. [20][21][22] US is more sensitive and reproducible than clinical evaluation in assessing joint inflammation.…”

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confidence: 99%

Assessment of inflammatory activity in rheumatoid arthritis: a comparative study of clinical evaluation with grey scale and power Doppler ultrasonography

Naredo¹,

Bonilla²,

Gamero³

et al. 2004

Annals of the Rheumatic Diseases

401

264

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Objective: To compare the clinical assessment of overall inflammatory activity in patients with rheumatoid arthritis (RA) with grey scale and power Doppler (PD) ultrasonography (US). Methods: Ninety four consecutive patients with RA were included. Demographic and clinical data, C reactive protein (CRP) level, and erythrocyte sedimentation rate (ESR) were recorded for each patient. The presence of tenderness, swelling, and a subjective swelling score from 1 to 3 were independently assessed by two rheumatologists, who reached a consensus in 60 joints examined in each patient. All patients underwent a US examination by a third blinded rheumatologist, using PD. US joint effusion, synovitis, and PD signal were graded from 1 to 3 in the 60 joints. Joint count and joint index for effusion, synovitis, and PD signal were recorded. A 28 joint count for clinical and US variables was calculated. Interobserver reliability of the US examination was evaluated by a fourth blinded rheumatologist. Results: US showed significantly more joints with effusion (mean 15.2) and synovitis (mean 14.6) than clinical examination (mean 11.5, p,0.05). A significant correlation was found between joint count and joint index for swelling, US effusion, synovitis, and PD signal. The 28 joint count for effusion, synovitis, and PD signal correlated highly with the corresponding 60 joint counts. US findings correlated better with CRP and ESR than clinical measures. Interobserver reliability was better for US findings than for clinical assessment. Conclusion: US is a sensitive method for assessing joint inflammatory activity in RA, complementary to clinical evaluation.

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“…A difference of effusion thickness greater than 2 mm in children and 1 mm in adults should raise concern for a pathologic effusion. [17][18][19][20] Although often dark and anechoic, effusions can be heterogeneous, especially in cases of purulent effusion. 21 Unfortunately, ultrasound characteristics of a hip effusion lack the accuracy to distinguish a septic from an aseptic effusion.…”

Section: Identifying a Hip Effusionmentioning

confidence: 99%

The Role of Ultrasound in the Emergency Department Evaluation of the Acutely Painful Pediatric Hip

Plumb¹,

Mallin²,

Bolte³

2015

Pediatric Emergency Care

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Children presenting with hip pain or a limp are a diagnostic challenge for the clinician. The differential diagnosis is extensive, and the workup can be broad. This review focuses on differentiating between transient synovitis and septic arthritis of the hip. The role of bedside ultrasound in the clinical evaluation of these patients is addressed, including the technique and appropriate indications for bedside ultrasound of the hip in the emergency department.

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Hip Joint Ultrasonography: Correlation With Intra-Articular Effusion and Synovitis

Cited by 51 publications

References 0 publications

Dose reduction of recombinant human tumor necrosis factor inhibitors (etanercept) can be effective in ankylosing spondylitis patients with synovitis of the hip in a Chinese population

Dose reduction of recombinant human tumor necrosis factor inhibitors (etanercept) can be effective in ankylosing spondylitis patients with synovitis of the hip in a Chinese population

Assessment of inflammatory activity in rheumatoid arthritis: a comparative study of clinical evaluation with grey scale and power Doppler ultrasonography

The Role of Ultrasound in the Emergency Department Evaluation of the Acutely Painful Pediatric Hip

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