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01.05.2013 | Original Article

Ultrasonography is a potent tool for the prediction of progressive joint destruction during clinical remission of rheumatoid arthritis

verfasst von: Ryusuke Yoshimi, Maasa Hama, Kaoru Takase, Atsushi Ihata, Daiga Kishimoto, Kayo Terauchi, Reikou Watanabe, Takeaki Uehara, Sei Samukawa, Atsuhisa Ueda, Mitsuhiro Takeno, Yoshiaki Ishigatsubo

Erschienen in: Modern Rheumatology | Ausgabe 3/2013

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Abstract

Objectives

Although “clinical remission” has been a realistic goal of treatment in rheumatoid arthritis (RA), there is evidence that subclinical synovitis is associated with ongoing structural damage even after clinical remission is achieved. In the study reported here, we assessed whether ultrasonography (US) can predict progressive joint destruction during clinical remission of RA.

Methods

Thirty-one patients with RA in clinical remission based on the disease activity score in 28 joints were recruited for this study. Bilateral wrists and all of the metacarpophalangeal and proximal interphalangeal (PIP) joints were examined by power Doppler (PD) ultrasonography (US), and the PD signals were scored semiquantitatively in each joint. The total PD score was calculated as the sum of individual scores for each joint.

Results

Among 22 RA patients who maintained clinical remission during the 2-year follow-up period, seven showed radiographic progression. Radiographic progression was strongly associated with total PD score at entry, with all patients showing radiographic progression having a total PD score of ≥2 at entry and none of the patients with a total PD score of ≤1 showing any radiographic progression. There was no significant association of therapeutic agents with progressing or non-progressing cases.

Conclusions

PD-US detects synovitis causing joint destruction even when the patient is in clinical remission. Thus, remission visible on US is essential to reach “true remission” of RA.

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Titel: Ultrasonography is a potent tool for the prediction of progressive joint destruction during clinical remission of rheumatoid arthritis
verfasst von: Ryusuke Yoshimi
Maasa Hama
Kaoru Takase
Atsushi Ihata
Daiga Kishimoto
Kayo Terauchi
Reikou Watanabe
Takeaki Uehara
Sei Samukawa
Atsuhisa Ueda
Mitsuhiro Takeno
Yoshiaki Ishigatsubo
Publikationsdatum: 01.05.2013
Verlag: Springer Japan
Erschienen in: Modern Rheumatology / Ausgabe 3/2013
Print ISSN: 1439-7595
Elektronische ISSN: 1439-7609
DOI: https://doi.org/10.1007/s10165-012-0690-1

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Ultrasonography is a potent tool for the prediction of progressive joint destruction during clinical remission of rheumatoid arthritis

Abstract

Objectives

Methods

Results

Conclusions

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Parodontalbehandlung verbessert Prognose bei Katheterablation

Antihypertensiva schützen auch alte Menschen noch vor Demenz

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Denken Sie bei starker Blutung auch an die Hemmkörper-Hämophilie

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Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

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Abstract

Objectives

Methods

Results

Conclusions

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