Skip to main content
Erschienen in: Clinical Rheumatology 4/2017

19.12.2016 | Brief Report

Ultrasound resistive index, power Doppler, and clinical parameters in established rheumatoid arthritis

verfasst von: Melissa Cláudia Bisi, Aline Defaveri do Prado, Deise Marcela Piovesan, Markus Bredemeier, Inês Guimarães da Silveira, José Alexandre de Mendonça, Henrique Luiz Staub

Erschienen in: Clinical Rheumatology | Ausgabe 4/2017

Einloggen, um Zugang zu erhalten

Abstract

Ultrasonography (US) is a useful tool for the evaluation of sinovial vascularization and proliferation in rheumatoid arthritis (RA). Accordingly, resistive index (RI) on spectral Doppler (sD) US provides a quantitative analysis of vascular inflammation, but its utility in the evaluation of RA activity has not been established. Our objective was to determine the association of RI with other US parameters of synovitis and with clinical disease activity in established RA. Patients with positive power Doppler (pD) were included in a prospective cross-sectional study. Disease activity and disability were evaluated using the Disease Activity Score in 28-joints (DAS28) and Health Assessment Questionnaire (HAQ), respectively. Gray scale (GS) synovitis, pD, and sD analyses were performed by one of two examiners in wrists and the second and third metacarpophalangeal and proximal interphalangeal joints. The 10-joint GS and 10-joint pD scores and mean RI were then calculated. Weighted kappa (WK) values were employed to assess interobserver reability, and correlations were tested using the Spearman coefficient. Ninety-five RA patients (median duration of disease of 7 years and mean DAS28 of 4.32 ± 1.66) were included. WK values in real-time US were 0.77 for synovitis, 0.87 for pD, and 0.68 for RI. There were no significant correlations of RI with 10-joint GS, 10-joint pD, DAS28, joint counts, or HAQ (P > 0.10 for all tests). Patients in remission had a mean RI similar to those with high disease activity (0.62 ± 0.10, n = 15 versus 0.63 ± 0.13, n = 34, respectively). The addition of the RI score did not seem to improve US performance in patients with established RA.
Literatur
1.
Zurück zum Zitat Bone P, Mader R (2013) Rheumatoid arthritis. In: Kelley’s Textbook of Rheumatology, 6th ed. Philadelphia, W B Saunders, 1680–1691 p Bone P, Mader R (2013) Rheumatoid arthritis. In: Kelley’s Textbook of Rheumatology, 6th ed. Philadelphia, W B Saunders, 1680–1691 p
2.
Zurück zum Zitat Firestein GS (2005) Immunologic mechanisms in the pathogenesis of rheumatoid arthritis. J Clin Rheumatol 11(3 Suppl):S39–S44CrossRefPubMed Firestein GS (2005) Immunologic mechanisms in the pathogenesis of rheumatoid arthritis. J Clin Rheumatol 11(3 Suppl):S39–S44CrossRefPubMed
3.
Zurück zum Zitat Naredo E, Bonilla G, Gamero F, Uson J, Carmona L, Laffon A (2005) Assessment of inflammatory activity in rheumatoid arthritis: a comparative study of clinical evaluation with grey scale and power Doppler ultrasonography. Ann Rheum Dis 64(3):375–381CrossRefPubMedPubMedCentral Naredo E, Bonilla G, Gamero F, Uson J, Carmona L, Laffon A (2005) Assessment of inflammatory activity in rheumatoid arthritis: a comparative study of clinical evaluation with grey scale and power Doppler ultrasonography. Ann Rheum Dis 64(3):375–381CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Schmidt WA (2007) Technology insight: the role of color and power Doppler ultrasonography in rheumatology. Nat Clin Pract Rheumatol 3(1):35–42 quiz 59CrossRefPubMed Schmidt WA (2007) Technology insight: the role of color and power Doppler ultrasonography in rheumatology. Nat Clin Pract Rheumatol 3(1):35–42 quiz 59CrossRefPubMed
5.
Zurück zum Zitat Terslev L, Torp-Pedersen S, Bang N, Koenig MJ, Nielsen MB, Bliddal H (2005) Doppler ultrasound findings in healthy wrists and finger joints before and after use of two different contrast agents. Ann Rheum Dis 64(6):824–827CrossRefPubMedPubMedCentral Terslev L, Torp-Pedersen S, Bang N, Koenig MJ, Nielsen MB, Bliddal H (2005) Doppler ultrasound findings in healthy wrists and finger joints before and after use of two different contrast agents. Ann Rheum Dis 64(6):824–827CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31(3):315–324CrossRefPubMed Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31(3):315–324CrossRefPubMed
7.
Zurück zum Zitat Fries JF, Spitz P, Kraines RG, Holman HR (1980) Measurement of patient outcome in arthritis. Arthritis Rheum 23(2):137–145CrossRefPubMed Fries JF, Spitz P, Kraines RG, Holman HR (1980) Measurement of patient outcome in arthritis. Arthritis Rheum 23(2):137–145CrossRefPubMed
8.
Zurück zum Zitat Bruce B, Fries JF (2005) The Health Assessment Questionnaire (HAQ). Clin Exp Rheumatol 23(5 Suppl 39):S14–S18PubMed Bruce B, Fries JF (2005) The Health Assessment Questionnaire (HAQ). Clin Exp Rheumatol 23(5 Suppl 39):S14–S18PubMed
9.
Zurück zum Zitat da Luz KR (2012) Prospective evaluation of ultrasound features of wrists and metacarpophalangeal joints in early rheumatoid arthritis. Dissertation, Universidade Federal de São Paulo da Luz KR (2012) Prospective evaluation of ultrasound features of wrists and metacarpophalangeal joints in early rheumatoid arthritis. Dissertation, Universidade Federal de São Paulo
10.
Zurück zum Zitat OMERACT 7 Special Interest Group, Wakefield RJ, Balint PV, Szkudlarek M, Filippucci E, Backhaus M, D’Agostino MA et al (2005) Musculoskeletal ultrasound including denitions for ultrasonographic pathology. JRheumatol 32:2485–2487 OMERACT 7 Special Interest Group, Wakefield RJ, Balint PV, Szkudlarek M, Filippucci E, Backhaus M, D’Agostino MA et al (2005) Musculoskeletal ultrasound including denitions for ultrasonographic pathology. JRheumatol 32:2485–2487
11.
Zurück zum Zitat Szkudlarek M, Court-Payen M, Stranberg C, Klarlund M, Klausen T, Ostergaard M (2001) The power Doppler ultrasonography for assessment of synovitis in metacarpophalangeal joints of patients with rheumatoid arthritis. A comparison with dynamic magnetic resonance imaging. Arthritis Rheum 44:2018–2023CrossRefPubMed Szkudlarek M, Court-Payen M, Stranberg C, Klarlund M, Klausen T, Ostergaard M (2001) The power Doppler ultrasonography for assessment of synovitis in metacarpophalangeal joints of patients with rheumatoid arthritis. A comparison with dynamic magnetic resonance imaging. Arthritis Rheum 44:2018–2023CrossRefPubMed
12.
Zurück zum Zitat Terslev L, Torp-Pedersen S, Qvistgaard E, Bliddal H (2003) Spectral Doppler and resistive index. A promising tool in ultrasonographic evaluation of inflammation in rheumatoid arthritis. Acta Radiol 44(6):645–652PubMed Terslev L, Torp-Pedersen S, Qvistgaard E, Bliddal H (2003) Spectral Doppler and resistive index. A promising tool in ultrasonographic evaluation of inflammation in rheumatoid arthritis. Acta Radiol 44(6):645–652PubMed
13.
Zurück zum Zitat Cohen J (1960) A coefficient of agreement for nominal scales. Education and Psychological Measurement 37–46 p Cohen J (1960) A coefficient of agreement for nominal scales. Education and Psychological Measurement 37–46 p
14.
Zurück zum Zitat Lainer-Carr D, Brahn E (2007) Angiogenesis inhibition as a therapeutic approach for inflammatory synovitis. Nat Clin Pract Rheumatol 3(8):434–442CrossRefPubMed Lainer-Carr D, Brahn E (2007) Angiogenesis inhibition as a therapeutic approach for inflammatory synovitis. Nat Clin Pract Rheumatol 3(8):434–442CrossRefPubMed
15.
Zurück zum Zitat Porta F, Radunovic G, Vlad V, Micu MC, Nestorova R, Petranova T et al (2012) The role of Doppler ultrasound in rheumatic diseases. Rheumatology 51(6):976–982CrossRefPubMed Porta F, Radunovic G, Vlad V, Micu MC, Nestorova R, Petranova T et al (2012) The role of Doppler ultrasound in rheumatic diseases. Rheumatology 51(6):976–982CrossRefPubMed
16.
Zurück zum Zitat Terslev L, von der Recke P, Torp-Pedersen S, Koenig MJ, Bliddal H (2008) Diagnostic sensitivity and specificity of Doppler ultrasound in rheumatoid arthritis. J Rheumatol 35(1):49–53PubMed Terslev L, von der Recke P, Torp-Pedersen S, Koenig MJ, Bliddal H (2008) Diagnostic sensitivity and specificity of Doppler ultrasound in rheumatoid arthritis. J Rheumatol 35(1):49–53PubMed
17.
Zurück zum Zitat Carotti M, Salaffi F, Morbiducci J, Ciapetti A, Bartolucci L, Gasparini S et al (2012) Colour Doppler ultrasonography evaluation of vascularization in the wrist and finger joints in rheumatoid arthritis patients and healthy subjects. Eur J Radiol 81(8):1834–1838CrossRefPubMed Carotti M, Salaffi F, Morbiducci J, Ciapetti A, Bartolucci L, Gasparini S et al (2012) Colour Doppler ultrasonography evaluation of vascularization in the wrist and finger joints in rheumatoid arthritis patients and healthy subjects. Eur J Radiol 81(8):1834–1838CrossRefPubMed
18.
Zurück zum Zitat Terslev L, Torp-Pedersen S, Qvistgaard E, Kristoffersen H, Røgind H, Danneskiold-Samsøe B et al (2003) Effects of treatment with etanercept (Enbrel, TNRF: Fc) on rheumatoid arthritis evaluated by Doppler ultrasonography. Ann Rheum Dis 62(2):178–181CrossRefPubMedPubMedCentral Terslev L, Torp-Pedersen S, Qvistgaard E, Kristoffersen H, Røgind H, Danneskiold-Samsøe B et al (2003) Effects of treatment with etanercept (Enbrel, TNRF: Fc) on rheumatoid arthritis evaluated by Doppler ultrasonography. Ann Rheum Dis 62(2):178–181CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Terslev L, Torp-Pedersen S, Qvistgaard E, Danneskiold-Samsoe B, Bliddal H (2003) Estimation of inflammation by Doppler ultrasound: quantitative changes after intra-articular treatment in rheumatoid arthritis. Ann Rheum Dis 62(11):1049–1053CrossRefPubMedPubMedCentral Terslev L, Torp-Pedersen S, Qvistgaard E, Danneskiold-Samsoe B, Bliddal H (2003) Estimation of inflammation by Doppler ultrasound: quantitative changes after intra-articular treatment in rheumatoid arthritis. Ann Rheum Dis 62(11):1049–1053CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Varsamidis K, Varsamidou E, Tjetjis V, Mavropoulos G (2005) Doppler sonography in assessing disease activity in rheumatoid arthritis. Ultrasound Med Biol 31(6):739–743CrossRefPubMed Varsamidis K, Varsamidou E, Tjetjis V, Mavropoulos G (2005) Doppler sonography in assessing disease activity in rheumatoid arthritis. Ultrasound Med Biol 31(6):739–743CrossRefPubMed
21.
Zurück zum Zitat Ranjan S, Jahan A, Yadav TP, Sachdev N, Dewan V, Singh S (2014) Evaluation of synovial inflammation in juvenile idiopathic arthritis by power color Doppler and spectral Doppler ultrasonography. Indian J Pediatric 81(1):29–35CrossRef Ranjan S, Jahan A, Yadav TP, Sachdev N, Dewan V, Singh S (2014) Evaluation of synovial inflammation in juvenile idiopathic arthritis by power color Doppler and spectral Doppler ultrasonography. Indian J Pediatric 81(1):29–35CrossRef
22.
Zurück zum Zitat Qvistgaard E, Røgind H, Torp-Pedersen S, Terslev L, Danneskiold-Samsøe B, Bliddal H (2001) Quantitative ultrasonography in rheumatoid arthritis: evaluation of inflammation by Doppler technique. Ann Rheum Dis 60(7):690–693CrossRefPubMedPubMedCentral Qvistgaard E, Røgind H, Torp-Pedersen S, Terslev L, Danneskiold-Samsøe B, Bliddal H (2001) Quantitative ultrasonography in rheumatoid arthritis: evaluation of inflammation by Doppler technique. Ann Rheum Dis 60(7):690–693CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Kiris A, Ozgocmen S, Kocakoc E, Ardicoglu O (2006) Power Doppler assessment of overall disease activity in patients with rheumatoid arthritis. J Clin Ultrasound 34(1):5–11CrossRefPubMed Kiris A, Ozgocmen S, Kocakoc E, Ardicoglu O (2006) Power Doppler assessment of overall disease activity in patients with rheumatoid arthritis. J Clin Ultrasound 34(1):5–11CrossRefPubMed
24.
Zurück zum Zitat Ozgocmen S, Kiris A, Kocakoc E, Ardicoglu O, Kamanli A (2004) Evaluation of metacarpophalangeal joint synovitis in rheumatoid arthritis by power Doppler technique: relationship between synovial vascularization and periarticular bone mineral density. Joint Bone Spine 71(5):384–388CrossRefPubMed Ozgocmen S, Kiris A, Kocakoc E, Ardicoglu O, Kamanli A (2004) Evaluation of metacarpophalangeal joint synovitis in rheumatoid arthritis by power Doppler technique: relationship between synovial vascularization and periarticular bone mineral density. Joint Bone Spine 71(5):384–388CrossRefPubMed
Metadaten
Titel
Ultrasound resistive index, power Doppler, and clinical parameters in established rheumatoid arthritis
verfasst von
Melissa Cláudia Bisi
Aline Defaveri do Prado
Deise Marcela Piovesan
Markus Bredemeier
Inês Guimarães da Silveira
José Alexandre de Mendonça
Henrique Luiz Staub
Publikationsdatum
19.12.2016
Verlag
Springer London
Erschienen in
Clinical Rheumatology / Ausgabe 4/2017
Print ISSN: 0770-3198
Elektronische ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-016-3507-3

Weitere Artikel der Ausgabe 4/2017

Clinical Rheumatology 4/2017 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.