Need for Greater Attention to Joint Damage in Rhupus Patients: Results from an Ultrasound Study

Abstract

Background The aim of this study was to evaluate the prevalence of inflammation and bone destruction of hand joints in rhupus patients through ultrasound examination. Material/Methods Ten rhupus patients and 33 systemic lupus erythematosus (SLE) patients with hand arthropathy were recruited in this single-center study, and the clinical features and ultrasound manifestations of these patients were analyzed. Results We discovered that rhupus patients were older (47.31±4.35 years vs. 38.58±2.50 years, P =0.040), had longer duration of disease (median 72 months vs. median 12 months, P =0.040), had a higher positive rate (70% vs. 10.71%, P <0.001), and had higher titers of anti-CCP antibody (42.633±14.520 vs. 2.121±0.970, P <0.001) than SLE patients with arthropathy. More importantly, the prevalence rates of synovial hyperplasia (90% vs. 42.42%, P =0.008), synovitis (90% vs. 18.18%, P <0.001), synovial hyperplasia (70% vs. 10.71%, P <0.001), and bone destruction (70% vs. 6.06%, P <0.001) were higher in rhupus patients than in SLE patients with arthropathy. Conclusions Rhupus patients are more prone to develop synovitis, synovial hyperplasia, and bone destruction. Therefore, more attention should be paid to protection of the joints in rhupus patients.

Case report: Joint deformity associated with systemic lupus erythematosus

“…However, the 1987 ACR criteria included bone erosion in the RA diagnostic criteria, and inflammatory bone erosion is a characteristic manifestation of RA 33 . Rhupus is characterized by bone erosion, similar to RA 34 . In contrast, JA is characterized by joint deformation, without bone erosion.…”

“… 33 Rhupus is characterized by bone erosion, similar to RA. 34 In contrast, JA is characterized by joint deformation, without bone erosion. Therefore, we believe that the presence of bone erosion should be regarded as the key to distinguishing rhupus from JA.…”