Detecting joints with erosion(s) in rheumatoid arthritis: a novel individualized-ultrasound method performs better than existing methods
AbstractPurposeTo determine if a novel individualized-ultrasound (IUS) method can detect more joints with erosion(s) in rheumatoid arthritis (RA) patients versus existing methods.Materials and methodsThe IUS method selects up to 7 or 14 ultrasonographically most inflamed joints whereas existing methods pre-fix 7 or 14 joints for ultrasonography. Using ultrasonography, the mean total inflammatory score (TIS), mean number of affected joints and mean number of joints with erosion(s) were compared between novel and existing methods among 30 RA patients using the paired Studentt test.ResultsUsing 7-joint approach, comparing IUS versus existing methods, the mean (95% CI) for TIS, number of affected joints, and number of joints with erosion(s) were: 2.18 (1.88, 2.48) versus 0.95 (0.78, 1.11); 7 (7, 7) versus 4.43 (3.93, 4.94); 3.20 (2.44, 3.96) versus 1.33 (0.94, 1.72), respectively. Using 14-joint approach, comparing IUS versus existing methods, the mean (95% CI) for TIS, number of affected joints, and number of joints with erosion(s) were: 3.17 (2.75, 3.6) versus 1.71 (1.38, 2.04); 13.5 (13.05, 13.95) versus 8.13 (7.24, 9.02); 4.23 (3.13, 5.34) versus 2.77 (2.03, 3.50), respectively.p values all
CONCLUSIONS: Currently, rheumatologists would not accept a domain as more important than others in remission. Our suggestion is, not to generate a universal definition of remission - one that could cover all aspects - but rather to develop definitions of remission for the different settings that could be pondered by the patient's perspective. PMID: 31573477 [PubMed - as supplied by publisher]
Conclusion: Rates of disagreement between clinical and US assessments of disease activity among RA patients are high and remain high during follow-up, even when the US assessors were aware of the clinical examination findings. Both clinical- and ultrasound- related factors were associated with discordances.
ConclusionWe identified the optimal joint cut-off scores for predicting recurrence and remission in RA patients. Risk-stratification therapy based on the ultrasound scores may improve outcome and quality of life for patients with RA.
A 32-year-old male patient with rheumatoid arthritis affecting multiple joints without rheumatoid factor returns to the office for a follow-up visit with the nurse practitioner (NP). The patient states his overall pain has improved since his previous visit, although he rates the severity of his right shoulder and right wrist pain at a 5 on... [Read More]
Condition: Rheumatoid Arthritis Intervention: Other: Ultrasound Sponsors: University Hospital, Montpellier; Centre Hospitalier Universitaire de Nīmes; University Hospital, Clermont-Ferrand; University Hospital, Bordeaux; University Hospital, Toulouse Not yet recruiting
CONCLUSION: US has high sensitivity and specificity in detecting RA inflammatory lesions in the ankle and rearfoot, in very good agreement with MRI. The high frequency of ankle inflammatory lesions in RA should result in increased interest in the imaging evaluation of these structures. PMID: 31476206 [PubMed - in process]
Conclusions: PET/CT images provide unique quantitative information that cannot be obtained from any other imaging modalities.
Publication date: Available online 30 August 2019Source: The Egyptian RheumatologistAuthor(s): Hanan M. Elshoura, Nayera Z. Saber, Mohamed A. Elwy, Mervat M. AbdelhakimAbstractAim of the workTo assess the effectiveness of perineural injection therapy (PIT) as a new modality in the management of chronic pain and dysfunction of the TMJ in RA patients and to study if it has any role in tissue regeneration.Patients and methodsOut of 19 RA patients with persistent TMJ involvement and pain despite receiving systemic treatment, 13 agreed to have PIT and only 11 completed the study; 21 TMJ (10 bilateral and 1 unilateral) were asse...
CONCLUSION: The RA-BIODAM prospective study succeeded in generating an extensive list of clinical, imaging (2343 radiographs), and biosample (4638 sera) resources that will be made available to expedite the identification and validation of biomarkers for radiographic damage endpoints. PMID: 31474600 [PubMed - as supplied by publisher]