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Value of ultrasonography for diagnosis of synovitis associated with rheumatoid arthritis
Author(s) -
Xiao Hua,
Liu Minghui,
Tan Lihua,
Liao Xiangping,
Li Yajun,
Gao Jiesheng,
Li Fen,
Xie Xi,
Peng Qinghai,
Mao Ni,
Tian Jing,
Du Jinfeng,
Chen Jinwei
Publication year - 2014
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.12390
Subject(s) - medicine , synovitis , erythrocyte sedimentation rate , rheumatoid arthritis , rheumatoid factor , wrist , magnetic resonance imaging , ultrasonography , synovial membrane , serology , nuclear medicine , pathology , radiology , antibody , immunology
Aim To investigate the value of ultrasonography ( US ) for diagnosing synovitis associated with rheumatoid arthritis ( RA ). Method Bilateral metacarpophalangeal ( MCP ), proximal interphalangeal ( PIP ) II – V and wrist joints of 46 RA patients and 35 healthy controls were evaluated by quantitative and semiquantitative US . Wrists on more severely affected sides of 20 of the 46 patients also underwent magnetic resonance imaging ( MRI ). The MRI and US results were compared. The US cutoff to distinguish pathology was calculated. The two US methods were compared and the correlation between quantitative methods and clinical serologic markers was analyzed. Results The imaging techniques ( US and MRI ) for detecting synovitis produced consistent results (γ = 0.70–0.77, P < 0.001). When the cutoffs for the MCP and PIP joints were 2.5 and 2.6 mm, respectively; the sensitivities/specificities were 82.8%/85.8% and 98.2%/84.8%, respectively. When the cutoff for the wrist was 5.2 mm, the sensitivity/specificity was 93.4%/93.4%. The average synovial membrane thickness was positively related to biochemical markers erythrocyte sedimentation rate, C‐reactive protein, anticyclic citrullinated peptide antibody, and D isease A ctivity Index of 28 joints (γ = 0.307–0.614; P = 0.020, 0.038, 0.01, < 0.001, respectively) but was poorly related to rheumatoid factor immunoglobulin A ( RF ‐ I g A ), RF ‐ I g M , and RF ‐ I g G (γ = 0.06–0.115; P = 0.45, 0.45, 0.62, respectively). Conclusions US is a valid method for diagnosing early‐stage synovitis, with high‐accuracy cutoffs for MCP , PIP and wrist joints set at 2.5, 2.6 and 5.2 mm. The mean synovial thicknesses of the bilateral wrist, MCP II – IV and PIP II – IV joints can be used to assess disease activity.