Cargando…
Assessing synovitis in the hands in patients with rheumatoid arthritis by ultrasound: an agreement study exploring the most inflammatory active side from two Norwegian trials
OBJECTIVE: To assess if the right hand, the dominant hand, or the hand with more clinically swollen joints (SwJ) is per se the most inflamed and exhibits the greatest change during treatment and hence preferred for unilateral scoring of synovitis by ultrasound in rheumatoid arthritis (RA) patients....
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6612125/ https://www.ncbi.nlm.nih.gov/pubmed/31277679 http://dx.doi.org/10.1186/s13075-019-1930-y |
_version_ | 1783432828934946816 |
---|---|
author | Terslev, Lene Christensen, Robin Aga, Anna-Birgitte Sexton, Joe Haavardsholm, Espen A. Hammer, Hilde B. |
author_facet | Terslev, Lene Christensen, Robin Aga, Anna-Birgitte Sexton, Joe Haavardsholm, Espen A. Hammer, Hilde B. |
author_sort | Terslev, Lene |
collection | PubMed |
description | OBJECTIVE: To assess if the right hand, the dominant hand, or the hand with more clinically swollen joints (SwJ) is per se the most inflamed and exhibits the greatest change during treatment and hence preferred for unilateral scoring of synovitis by ultrasound in rheumatoid arthritis (RA) patients. METHODS: Using data from two previously published Norwegian RA patient cohorts initiating treatment, bilateral metacarpophalangeal joint 1–5, proximal phalangeal joint 2+3, and wrists were evaluated by ultrasound. Using a 0–3 scoring system a grey-scale (GS), power Doppler (PD) and global synovitis score (GLOESS) was calculated for each hand (0–30). For precision, a difference of < ± 3 in sum score was pre-specified as indicating clinically insignificant difference in inflammatory activity for all three scores. RESULTS: Four hundred thirty-seven RA patients were included. Baseline ultrasound inflammation was statistically significantly higher in hands with more vs fewer SwJ ([mean difference, 95%CI] GS sum score 2.21[1.30 to 3.12], PD sum score 1.70 [0.94 to 2.47] and GLOESS 2.31[1.36 to 3.26]) and also exhibited significantly more change for all sum scores at 3 months follow-up (GS sum score 1.34 [0.60 to 2.08], PD sum score 1.17 [0.44 to 1.91], and GLOESS 1.43 [0.63 to 2.22]). No such differences were found between the dominant and the non-dominant or the right and the left hands at any time points. CONCLUSION: The hand with clinically more SwJ is statistically more inflammatory active according to GS, Doppler, and GLOESS sum scores, exhibits a change during treatment, and is potentially the best choice for unilateral scoring systems. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13075-019-1930-y) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6612125 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-66121252019-07-16 Assessing synovitis in the hands in patients with rheumatoid arthritis by ultrasound: an agreement study exploring the most inflammatory active side from two Norwegian trials Terslev, Lene Christensen, Robin Aga, Anna-Birgitte Sexton, Joe Haavardsholm, Espen A. Hammer, Hilde B. Arthritis Res Ther Research Article OBJECTIVE: To assess if the right hand, the dominant hand, or the hand with more clinically swollen joints (SwJ) is per se the most inflamed and exhibits the greatest change during treatment and hence preferred for unilateral scoring of synovitis by ultrasound in rheumatoid arthritis (RA) patients. METHODS: Using data from two previously published Norwegian RA patient cohorts initiating treatment, bilateral metacarpophalangeal joint 1–5, proximal phalangeal joint 2+3, and wrists were evaluated by ultrasound. Using a 0–3 scoring system a grey-scale (GS), power Doppler (PD) and global synovitis score (GLOESS) was calculated for each hand (0–30). For precision, a difference of < ± 3 in sum score was pre-specified as indicating clinically insignificant difference in inflammatory activity for all three scores. RESULTS: Four hundred thirty-seven RA patients were included. Baseline ultrasound inflammation was statistically significantly higher in hands with more vs fewer SwJ ([mean difference, 95%CI] GS sum score 2.21[1.30 to 3.12], PD sum score 1.70 [0.94 to 2.47] and GLOESS 2.31[1.36 to 3.26]) and also exhibited significantly more change for all sum scores at 3 months follow-up (GS sum score 1.34 [0.60 to 2.08], PD sum score 1.17 [0.44 to 1.91], and GLOESS 1.43 [0.63 to 2.22]). No such differences were found between the dominant and the non-dominant or the right and the left hands at any time points. CONCLUSION: The hand with clinically more SwJ is statistically more inflammatory active according to GS, Doppler, and GLOESS sum scores, exhibits a change during treatment, and is potentially the best choice for unilateral scoring systems. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13075-019-1930-y) contains supplementary material, which is available to authorized users. BioMed Central 2019-07-05 2019 /pmc/articles/PMC6612125/ /pubmed/31277679 http://dx.doi.org/10.1186/s13075-019-1930-y Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Terslev, Lene Christensen, Robin Aga, Anna-Birgitte Sexton, Joe Haavardsholm, Espen A. Hammer, Hilde B. Assessing synovitis in the hands in patients with rheumatoid arthritis by ultrasound: an agreement study exploring the most inflammatory active side from two Norwegian trials |
title | Assessing synovitis in the hands in patients with rheumatoid arthritis by ultrasound: an agreement study exploring the most inflammatory active side from two Norwegian trials |
title_full | Assessing synovitis in the hands in patients with rheumatoid arthritis by ultrasound: an agreement study exploring the most inflammatory active side from two Norwegian trials |
title_fullStr | Assessing synovitis in the hands in patients with rheumatoid arthritis by ultrasound: an agreement study exploring the most inflammatory active side from two Norwegian trials |
title_full_unstemmed | Assessing synovitis in the hands in patients with rheumatoid arthritis by ultrasound: an agreement study exploring the most inflammatory active side from two Norwegian trials |
title_short | Assessing synovitis in the hands in patients with rheumatoid arthritis by ultrasound: an agreement study exploring the most inflammatory active side from two Norwegian trials |
title_sort | assessing synovitis in the hands in patients with rheumatoid arthritis by ultrasound: an agreement study exploring the most inflammatory active side from two norwegian trials |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6612125/ https://www.ncbi.nlm.nih.gov/pubmed/31277679 http://dx.doi.org/10.1186/s13075-019-1930-y |
work_keys_str_mv | AT terslevlene assessingsynovitisinthehandsinpatientswithrheumatoidarthritisbyultrasoundanagreementstudyexploringthemostinflammatoryactivesidefromtwonorwegiantrials AT christensenrobin assessingsynovitisinthehandsinpatientswithrheumatoidarthritisbyultrasoundanagreementstudyexploringthemostinflammatoryactivesidefromtwonorwegiantrials AT agaannabirgitte assessingsynovitisinthehandsinpatientswithrheumatoidarthritisbyultrasoundanagreementstudyexploringthemostinflammatoryactivesidefromtwonorwegiantrials AT sextonjoe assessingsynovitisinthehandsinpatientswithrheumatoidarthritisbyultrasoundanagreementstudyexploringthemostinflammatoryactivesidefromtwonorwegiantrials AT haavardsholmespena assessingsynovitisinthehandsinpatientswithrheumatoidarthritisbyultrasoundanagreementstudyexploringthemostinflammatoryactivesidefromtwonorwegiantrials AT hammerhildeb assessingsynovitisinthehandsinpatientswithrheumatoidarthritisbyultrasoundanagreementstudyexploringthemostinflammatoryactivesidefromtwonorwegiantrials |