[Value of musculoskeletal ultrasound in assessing the disease activity in rheumatoid arthritis]

Zhonghua Yi Xue Za Zhi. 2019 Apr 2;99(13):1008-1011. doi: 10.3760/cma.j.issn.0376-2491.2019.13.010.
[Article in Chinese]

Abstract

Objective: To investigate the value of musculoskeletal ultrasound (MSUS) in assessing the disease activity of rheumatoid arthritis (RA). Methods: As a retrospective study, clinical data, laboratory test results and MSUS results of 22 joints (2 wrist joints, 10 metacarpophalangeal joints, 2 thumb interphalangeal joints, 8 proximal interphalangeal joints) were collected from 403 hospitalized RA patients (including Han and Uygur patients) in the People's Hospital of the Xinjiang Uygur Autonomous Region from January 2016 to December 2016. Result: (1) There was a positive correlation between swollen joints count, tender joints count, erythrocyte sedimentation rate, C-reaction protein and sum scores of articular cavity effusion, Grey Scale (GS), Power Doppler (PD), tenosynovitis in RA patients; (2)there was a positive correlation between DAS28-ESR, DAS28-CRP, SDAI, CDAI and sum scores of effusion, GS, PD, tenosynovitis in RA patients. The ulnar extensor tendon of the wrist of RA patients was more susceptible to extensor tendon than other extensor tendons; (3)there was significant statistical difference between Uygur and Han RA patients in bone erosion (P<0.05), however the statistical difference between Uygur and Han RA patients in effusion, GS or PD score was not significant (P>0.05). Few Uygur RA patients achieved clinical remission and subclinical synovitis was not detected, while such subclinical synovitis was detected in Han RA patients who achieved clinical remission. Conclusion: The MUSU can assess the disease activity of RA patients, and provide a more direct and objective evidence for the rapid evaluation of disease.

目的: 探讨肌肉骨骼超声(MSUS)在评估类风湿关节炎(RA)疾病活动度中的价值。 方法: 系统性回顾收集自2016年1至12月在新疆维吾尔自治区人民医院风湿免疫科住院并完成双腕、双手第1~5掌指关节、第1指间关节,第2~5近端指间关节共22个关节MSUS的403例汉族及维吾尔族RA患者的临床及实验室资料。 结果: (1)RA患者关节肿胀数、关节压痛数、血红细胞沉降率(ESR)、C反应蛋白(CRP)与MSUS评估的关节腔积液总和、滑膜增生评分总和、滑膜炎评分总和、肌腱炎评分总和呈正相关;(2)RA患者疾病活动度(DAS28)-ESR、DAS28-CRP、简化疾病活动指数(SDAI)、临床疾病活动指数(CDAI)与MSUS评估的双腕关节腔积液总和、滑膜增生评分总和、滑膜炎评分总和、肌腱炎评分总和呈正相关;RA患者腕关节尺侧伸肌腱较其他伸肌腱更易受累;(3)维吾尔族RA患者与汉族RA患者在骨侵蚀差异有统计学意义(P<0.05),而在关节腔积液、滑膜增生及滑膜炎方面差异无统计学意义(P>0.05),维吾尔族RA患者临床缓解例数少,未发现亚临床滑膜炎,而在汉族RA临床缓解的患者中仍发现亚临床滑膜炎存在。 结论: 在临床工作中,MSUS可以评估RA患者疾病活动度,为快速评估病情提供更直接、客观的证据。.

Keywords: Disease activity; Musculoskeletal ultrasound; Rheumatoid arthritis.

MeSH terms

  • Arthritis, Rheumatoid* / diagnostic imaging
  • Humans
  • Retrospective Studies
  • Severity of Illness Index
  • Synovitis*
  • Ultrasonography