Assessment of Disease Activity in Rheumatoid Arthritis: A Comparative Study of Clinical and Laboratory Evaluation with Musculoskeletal Ultrasonography Assessment.


Journal

The Journal of the Association of Physicians of India
ISSN: 0004-5772
Titre abrégé: J Assoc Physicians India
Pays: India
ID NLM: 7505585

Informations de publication

Date de publication:
Feb 2022
Historique:
entrez: 19 4 2022
pubmed: 20 4 2022
medline: 21 4 2022
Statut: ppublish

Résumé

Rheumatoid arthritis (RA) is a chronic inflammatory disease and musculoskeletal ultrasonography (USG) is gaining popularity for assessing the disease activity bed side, objectively and cost effectively. There is paucity of such studies from India which establish the correlation between RA disease activity and musculoskeletal USG. The objective of this study was to compare the disease activity scores in RA patients, assessed by 'clinical and laboratory evaluation' with 'musculoskeletal ultrasound scoring of the affected joints. It was a cross sectional study conducted from December 2015to May 2017. We enrolled the diagnosed patients of RA, having at least one USG assessable joint with definite clinical synovitis. Disease activity was assessed by swollen joint count, tender joint count, Clinical Disease Activity Index (CDAI), Disease Activity Score (DAS) 28 ESR and DAS 28 CRP. Musculoskeletal USG was performed by experienced radiologist. Grayscale scores (GSUS) and Power Doppler scores (PDUS) were calculated in 22 joints as per SONAR criteria and each joint was examined as per standardized score. Our study showed that DAS 28 CRP, DAS 28 ESR, CDAI, tender joint count and swollen joints count had positive correlation (p<0.001) with various ;musculoskeletal USG scores, whereas ESR and CRP failed to show any significant correlation.;Conclusion:;;GSUS-PDUS can be used for diagnosing joint space narrowing, joint effusion, and synovial thickening.;PD may become a cost-effective alternative to gadolinium enhanced MRI.;Strong correlation exists between USG and physical examination of joint swelling as;well as disease activity scores in RA patients.

Sections du résumé

BACKGROUND BACKGROUND
Rheumatoid arthritis (RA) is a chronic inflammatory disease and musculoskeletal ultrasonography (USG) is gaining popularity for assessing the disease activity bed side, objectively and cost effectively. There is paucity of such studies from India which establish the correlation between RA disease activity and musculoskeletal USG.
OBJECTIVE OBJECTIVE
The objective of this study was to compare the disease activity scores in RA patients, assessed by 'clinical and laboratory evaluation' with 'musculoskeletal ultrasound scoring of the affected joints.
METHODOLOGY METHODS
It was a cross sectional study conducted from December 2015to May 2017. We enrolled the diagnosed patients of RA, having at least one USG assessable joint with definite clinical synovitis. Disease activity was assessed by swollen joint count, tender joint count, Clinical Disease Activity Index (CDAI), Disease Activity Score (DAS) 28 ESR and DAS 28 CRP. Musculoskeletal USG was performed by experienced radiologist. Grayscale scores (GSUS) and Power Doppler scores (PDUS) were calculated in 22 joints as per SONAR criteria and each joint was examined as per standardized score.
RESULTS RESULTS
Our study showed that DAS 28 CRP, DAS 28 ESR, CDAI, tender joint count and swollen joints count had positive correlation (p<0.001) with various ;musculoskeletal USG scores, whereas ESR and CRP failed to show any significant correlation.;Conclusion:;;GSUS-PDUS can be used for diagnosing joint space narrowing, joint effusion, and synovial thickening.;PD may become a cost-effective alternative to gadolinium enhanced MRI.;Strong correlation exists between USG and physical examination of joint swelling as;well as disease activity scores in RA patients.

Identifiants

pubmed: 35436826

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

11-12

Informations de copyright

© Journal of the Association of Physicians of India 2011.

Auteurs

Anugrah Nair (A)

Senior Resident, Department of Cardiology, Amrita Institute of Medical Sciences, Kochi, Kerala; 2Associate Professor, Department of General Medicine, Asian Institute of Medical Sciences, Dehli NCR.

Punit Pruthi (P)

Associate Professor, Department of General Medicine, Asian Institute of Medical Sciences, Dehli NCR.

Sasikala L (S)

Assistant Professor, Department of General Medicine, Department of Rheumatology and Clinical Immunology, Amrita Institute of Medical Sciences, Kochi, Kerala.

Vishal Marwaha (V)

Principal and Professor, Department of Rheumatology and Clinical Immunology, Amrita Institute of Medical Sciences, Kochi, Kerala.

Sandeep Surendran (S)

Assistant Professor, Department of Rheumatology and Clinical Immunology, Amrita Institute of Medical Sciences, Kochi, Kerala.

Arun Tiwari (A)

Consultant, Department of Rheumatology and Clinical Immunology, Apollo Adlux Hospital, Kochi, Kerala; Corresponding Author.

Anne Rijo Mathew (AR)

Intern Doctor, Department of General Medicine, Amrita Institute of Medical Sciences, Kochi, Kerala.

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