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Extended 36‐joint sonographic examination: What it reveals about bone erosions in patients with rheumatoid arthritis
Author(s) -
Tan York Kiat,
Li HuiHua,
Allen John C.,
Thumboo Julian
Publication year - 2020
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.22785
Subject(s) - medicine , bone erosion , rheumatoid arthritis , arthritis , wrist , surgery
Purpose To identify joints commonly exhibiting bone erosions using an extended 36‐joint sonographic (US) examination in patients with rheumatoid arthritis (RA) and to study bone erosion in relation to US‐detected joint inflammation. Methods In this cross‐sectional study, power Doppler (PD) and gray‐scale (GS) joint inflammation scores (semi‐quantitative [0‐3] grading) at each joint recess were summed to obtain a combined US score (CUS). Bone erosion was scored as present/absent. Generalized Estimating Equations were used to compare mean US scores between joint recesses with and without bone erosion. Results Bone erosion was found in 144/1080 (13.3%) joints and 189/1800 (10.5%) joint recesses in 30 RA patients. The five joints most frequently associated with bone erosion were: wrist, n = 49/144 (34.0%); first MTPJ, n = 19/144 (13.2%); thumb IPJ, n = 13/144 (9.0%); second MCPJ, n = 11/144 (7.6%); and third MCPJ, n = 11/144 (7.6%). Mean (95% CI) US scores for joint recesses with and without bone erosion were PD: 0.36 (0.21, 0.50) vs 0.01 (0.00, 0.02); GS: 1.77 (1.54, 2.00) vs 0.47 (0.40, 0.55); and CUS: 2.13 (1.78, 2.47) vs 0.49 (0.41, 0.57) (all differences significant at P < .001). Conclusion The five joints most frequently showing bone erosion were identified. Joint recesses with bone erosion are more likely to exhibit greater PD and GS joint inflammation severity.