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Swollen, but not tender joints, are independently associated with ultrasound synovitis: results from a longitudinal observational study of patients with established rheumatoid arthritis

Hammer, Hilde Berner ; Michelsen, Brigitte ; Sexton, Joseph ; Haugen, Ida K ; Provan, Sella A ; Haavardsholm, Espen A ; Uhlig, Till ; Kvien, Tore K

Annals of the rheumatic diseases, 2019-09, Vol.78 (9), p.1179-1185 [Periódico revisado por pares]

England: BMJ Publishing Group LTD

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Título:
Swollen, but not tender joints, are independently associated with ultrasound synovitis: results from a longitudinal observational study of patients with established rheumatoid arthritis
Autor: Hammer, Hilde Berner ; Michelsen, Brigitte ; Sexton, Joseph ; Haugen, Ida K ; Provan, Sella A ; Haavardsholm, Espen A ; Uhlig, Till ; Kvien, Tore K
Assuntos: Ankle ; Arthritis, Rheumatoid - complications ; Arthritis, Rheumatoid - diagnosis ; Edema - diagnosis ; Edema - etiology ; Female ; Follow-Up Studies ; Health risk assessment ; Humans ; Inflammation ; Joint Capsule - diagnostic imaging ; Joint diseases ; Joints - diagnostic imaging ; Laboratories ; Longitudinal studies ; Male ; Middle Aged ; Observational studies ; Pain ; Patient Reported Outcome Measures ; Patients ; Regression analysis ; Rheumatoid arthritis ; Rheumatology ; ROC Curve ; Severity of Illness Index ; Synovitis ; Synovitis - complications ; Synovitis - diagnosis ; Ultrasonic imaging ; Ultrasonography - methods ; Ultrasound ; Wrist
É parte de: Annals of the rheumatic diseases, 2019-09, Vol.78 (9), p.1179-1185
Notas: ObjectType-Article-2
SourceType-Scholarly Journals-1
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Descrição: ObjectivesJoint swelling and tenderness are considered a proxy for inflammation in patients with rheumatoid arthritis (RA). With ultrasound-detected inflammation as reference, our objectives were to explore on patient and joint level the associations between ultrasound synovitis and joint swelling, tenderness and patient-reported joint pain (PRJP).Methods209 patients with established RA were examined six times during 12 months with assessment of 32 joints in upper/lower extremities for joint swelling/tenderness and Grey scale (GS)/power Doppler (PD) synovitis. PRJP was assessed on a manikin. Correlations between different sum scores were at each examination calculated using Spearman’s rho (r), agreement at joint level was examined by Cohen’s kappa and logistic regression models were used to explore the associations between joint assessment and GS/PD scores.ResultsAt patient level, swollen joints were strongly correlated with GS/PD sum scores (r=0.64–0.88), while tender joints were primarily associated with PRJP (r=0.54–0.68). At joint level, GS/PD pathology had higher agreement with swelling (kappa 0.54–0.57) than tenderness (kappa 0.20–0.21) or PRJP (0.23–0.25). Higher percentages of joints were swollen according to increasing GS/PD scores, independently of joint tenderness. However, joints being tender, but not swollen, were not associated with GS/PD scores. Receiver operating curves showed swollen but not tender joints to be associated with GS/PD scores.ConclusionsSwollen joints were strongly associated with ultrasound detected synovitis at both patient and joint level, while this association was not found for tender joints. These results may question if tender joints reflect ongoing inflammation in established RA.
Editor: England: BMJ Publishing Group LTD
Idioma: Inglês

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Swollen, but not tender joints, are independently associated with ultrasound synovitis: results from a longitudinal observational study of patients with established rheumatoid arthritis

Hammer, Hilde Berner ; Michelsen, Brigitte ; Sexton, Joseph ; Haugen, Ida K ; Provan, Sella A ; Haavardsholm, Espen A ; Uhlig, Till ; Kvien, Tore K

England: BMJ Publishing Group LTD

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