The challenge: to distinguish patients at risk for progression to RA from those who have non-rheumatic arthritis.
Reference1. Sahbudin I, Pickup L, Nightingale P, et al. The role of ultrasound-defined tenosynovitis and synovitis in the prediction of rheumatoid arthritis development. Rheumatology. 2018 Apr 3. doi: 10.1093/rheumatology/key025. [Epub ahead of print]
Sahbudin and fellow researchers in the UK have found that ultrasound (US) evidence of flexor tenosynovitis in the digits can independently predict later development of rheumatoid arthritis (RA).1 Scroll through the slides for the details of the study and the take-home points for physicians.
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RA, rheumatoid arthritis; TS, tenosynovitis; US, ultrasound.
Because of the increased risk of joint damage, pain, and disability if RA diagnosis and treatment are delayed, great interest exists in early detection.
ACR, American College of Rheumatology; DMARD, disease-modifying antirheumatic drug; EULAR, European League Against Rheumatism; RA, rheumatoid arthritis.
Patients in the study were recruited from the Birmingham Early Arthritis Clinic based in the Rheumatology Departments at Sandwell and West Birmingham Hospitals in the United Kingdom.
ACPA, anti-citrullinated protein antibody; GS, grey scale synovial hypertrophy; MCP, metacarpal phalangeal joint; MTP, metatarsal phalangeal joint; PD, power Doppler enhancement; PIP, proximal interphalangeal joint; RA, rheumatoid arthritis.
Logistic regression analysis identified PIP1 PD, digit flexor GS, and ACPA positivity as the variables that formed the model for the prediction of RA, with the proportion of RA vs non-RA identified as 75.7%.