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Ultrasound in clinically suspect arthralgia: the role of power Doppler to predict rheumatoid arthritis development
OBJECTIVE: To determine the usefulness of power Doppler (PD) ultrasound (US) to predict rheumatoid arthritis (RA) development in patients with clinically suspect arthralgia (CSA). METHODS: Retrospective analysis of a US unit cohort over a 1-year period. Patients with CSA and no previous diagnosis of...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8653555/ https://www.ncbi.nlm.nih.gov/pubmed/34876221 http://dx.doi.org/10.1186/s13075-021-02685-7 |
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author | Molina Collada, Juan López Gloria, Katerine Castrejón, Isabel Nieto-González, Juan Carlos Rivera, Javier Montero, Fernando González, Carlos Álvaro-Gracia, José María |
author_facet | Molina Collada, Juan López Gloria, Katerine Castrejón, Isabel Nieto-González, Juan Carlos Rivera, Javier Montero, Fernando González, Carlos Álvaro-Gracia, José María |
author_sort | Molina Collada, Juan |
collection | PubMed |
description | OBJECTIVE: To determine the usefulness of power Doppler (PD) ultrasound (US) to predict rheumatoid arthritis (RA) development in patients with clinically suspect arthralgia (CSA). METHODS: Retrospective analysis of a US unit cohort over a 1-year period. Patients with CSA and no previous diagnosis of inflammatory arthritis (IA) were included for analysis. All underwent bilateral US examination of the hands and/or feet according to the EULAR guidelines. Active US inflammation was defined as PD synovitis and/or tenosynovitis ≥1 at any location. RA diagnosis according to clinician criteria 6 months after the US examination was checked. Univariate and multivariate logistic regression models were employed to investigate possible predictive factors of RA development. RESULTS: A total of 110 CSA patients (80 females, mean age 53.6 years) were included for analysis. After 6 months of follow-up, 14 (12.7%) developed RA and 34 (30.9%) IA. US active inflammation was present in 38 (34.5%) patients (28.2% showed PD synovitis and 18.2% PD tenosynovitis). Multivariate analysis showed that ACPA (OR 1.0003; 95% CI 1.002–1.006) and ESR (OR 1.054; 95% CI 1.016–1.094) were significantly associated with the detection of US active inflammation at baseline. Only PD tenosynovitis was found to be an independent predictive factor of an evolution towards RA (OR 6.982; 95% CI 1.106–44.057) and IA (OR 5.360; 95% CI 1.012–28.390). CONCLUSION: US is able to detect features of subclinical inflammation in CSA patients, especially in those with higher ESR and ACPA values. Only PD tenosynovitis at baseline US assessment was found to be an independent predictor of RA and IA development in CSA patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13075-021-02685-7. |
format | Online Article Text |
id | pubmed-8653555 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-86535552021-12-08 Ultrasound in clinically suspect arthralgia: the role of power Doppler to predict rheumatoid arthritis development Molina Collada, Juan López Gloria, Katerine Castrejón, Isabel Nieto-González, Juan Carlos Rivera, Javier Montero, Fernando González, Carlos Álvaro-Gracia, José María Arthritis Res Ther Research Article OBJECTIVE: To determine the usefulness of power Doppler (PD) ultrasound (US) to predict rheumatoid arthritis (RA) development in patients with clinically suspect arthralgia (CSA). METHODS: Retrospective analysis of a US unit cohort over a 1-year period. Patients with CSA and no previous diagnosis of inflammatory arthritis (IA) were included for analysis. All underwent bilateral US examination of the hands and/or feet according to the EULAR guidelines. Active US inflammation was defined as PD synovitis and/or tenosynovitis ≥1 at any location. RA diagnosis according to clinician criteria 6 months after the US examination was checked. Univariate and multivariate logistic regression models were employed to investigate possible predictive factors of RA development. RESULTS: A total of 110 CSA patients (80 females, mean age 53.6 years) were included for analysis. After 6 months of follow-up, 14 (12.7%) developed RA and 34 (30.9%) IA. US active inflammation was present in 38 (34.5%) patients (28.2% showed PD synovitis and 18.2% PD tenosynovitis). Multivariate analysis showed that ACPA (OR 1.0003; 95% CI 1.002–1.006) and ESR (OR 1.054; 95% CI 1.016–1.094) were significantly associated with the detection of US active inflammation at baseline. Only PD tenosynovitis was found to be an independent predictive factor of an evolution towards RA (OR 6.982; 95% CI 1.106–44.057) and IA (OR 5.360; 95% CI 1.012–28.390). CONCLUSION: US is able to detect features of subclinical inflammation in CSA patients, especially in those with higher ESR and ACPA values. Only PD tenosynovitis at baseline US assessment was found to be an independent predictor of RA and IA development in CSA patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13075-021-02685-7. BioMed Central 2021-12-08 2021 /pmc/articles/PMC8653555/ /pubmed/34876221 http://dx.doi.org/10.1186/s13075-021-02685-7 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Molina Collada, Juan López Gloria, Katerine Castrejón, Isabel Nieto-González, Juan Carlos Rivera, Javier Montero, Fernando González, Carlos Álvaro-Gracia, José María Ultrasound in clinically suspect arthralgia: the role of power Doppler to predict rheumatoid arthritis development |
title | Ultrasound in clinically suspect arthralgia: the role of power Doppler to predict rheumatoid arthritis development |
title_full | Ultrasound in clinically suspect arthralgia: the role of power Doppler to predict rheumatoid arthritis development |
title_fullStr | Ultrasound in clinically suspect arthralgia: the role of power Doppler to predict rheumatoid arthritis development |
title_full_unstemmed | Ultrasound in clinically suspect arthralgia: the role of power Doppler to predict rheumatoid arthritis development |
title_short | Ultrasound in clinically suspect arthralgia: the role of power Doppler to predict rheumatoid arthritis development |
title_sort | ultrasound in clinically suspect arthralgia: the role of power doppler to predict rheumatoid arthritis development |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8653555/ https://www.ncbi.nlm.nih.gov/pubmed/34876221 http://dx.doi.org/10.1186/s13075-021-02685-7 |
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