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Clinical impact of musculoskeletal ultrasound on rheumatoid arthritis in routine care
Author(s) -
Molina Collada Juan,
Castrejón Isabel,
Pérez María,
NietoGonzález Juan Carlos,
González Teresa,
Rivera Javier,
González Carlos,
ÁlvaroGracia José María
Publication year - 2021
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.14040
Subject(s) - medicine , rheumatoid arthritis , logistic regression , referral , univariate analysis , physical therapy , multivariate analysis , family medicine
Objective To evaluate the impact of musculoskeletal ultrasound (MSUS) in the management of rheumatoid arthritis (RA) patients and to investigate factors affecting treatment strategy by the referring rheumatologist. Methods Prospective study of RA patients evaluated at a MSUS clinic over a 6‐month period. Data extraction included demographics, current treatment and MSUS findings. Pre‐ and post‐MSUS follow‐up of 3 months data were analyzed. Patients were classified into 2 groups based on the decision of the referring rheumatologist to change the treatment after the MSUS examination. Comparisons between groups were performed in a univariate analysis. We used logistic regression models to investigate factors associated with changes in clinical management. Results A total of 64 RA patients were included. Mean age was 61.9 years and 83.6% were female. Main referral indication was assessment of disease activity (89%). Overall, MSUS led to subsequent therapeutic actions by the referring rheumatologist in 41 (64.1%) patients, and to a change in the clinical impression of the complaint that generated the referral in 7 (11.5%) patients. The detection of power Doppler (PD), the 28 swollen joint count and the presence of radiographic erosions were significantly associated with a subsequent clinical action. In the multivariate analysis only PD remained significant (odds ratio = 3.29; 95% CI: 1.05‐10.26). Conclusion Disease activity evaluation is the most common indication for MSUS examination, with the presence of PD the factor most frequently associated with changes in therapeutic management. This study highlights the impact of MSUS, especially the use of PD, to support treatment decisions in RA routine care.