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Start Over Author "RCTS Lyon" Topic 0302 clinical medicine
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1. The ability of synovitis to predict structural damage in rheumatoid arthritis: a comparative study between clinical examination and ultrasound

Author

Maxime, Dougados, Valérie, Devauchelle-Pensec, Jean François, Ferlet, Sandrine, Jousse-Joulin, Maria-Antonietta, D'Agostino, Marina, Backhaus, Jacques, Bentin, Gérard, Chalès, Isabelle, Chary-Valckenaere, Philip, Conaghan, Richard J, Wakefield, Fabien, Etchepare, Frédéric, Etcheparre, Philippe, Gaudin, Walter, Grassi, Désirée van der, Heijde, Xavier, Mariette, Esperanza, Naredo, Marcin, Szkudlarek, Service de rhumatologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHRU Brest - Service de Rhumatologie (CHU - BREST - Rhumato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Statistique, RCTS, Lyon, RCTS Lyon, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Service de Rhumatologie, CHU Brugmann, CHU Brugmann, Belgium, CHU Pontchaillou [Rennes], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Section of Musculoskeletal Diseasee, University of Leeds, Academic Unit of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, Chapel Allerton Hospital, Université Pierre et Marie Curie - Paris 6 (UPMC), Service de Rhumatologie [CHU de Grenoble], Hôpital Sud de Grenoble, Univ Ancona, Politecn Marche, Leiden University Medical Center (LUMC), Universiteit Leiden, CHU Le Kremlin-Bicêtre (Rheumatology Department), Department of Rheumatology, Severo Ochoa Hospital, Hvidovre University Hospital, and University of Leeds & NIHR Leeds Musculoskeletal Biomedical Research Unit

Subjects
Male, Settore MED/16 - REUMATOLOGIA, MESH: Synovitis, Arthritis, Rheumatoid, 0302 clinical medicine, Risk Factors, MESH: Risk Factors, Rheumatoid, Immunologie, Immunology and Allergy, Medicine, 030212 general & internal medicine, Longitudinal Studies, Prospective Studies, Prospective cohort study, MESH: Longitudinal Studies, Ultrasonography, MESH: Aged, MESH: Arthritis, Rheumatoid, Synovitis, MESH: Middle Aged, medicine.diagnostic_test, Ultrasound, Doppler, MESH: Follow-Up Studies, Middle Aged, Connective tissue disease, MESH: Predictive Value of Tests, 3. Good health, MESH: Reproducibility of Results, Rhumatologie, MESH: Joints, Rheumatoid arthritis, Predictive value of tests, Disease Progression, Female, MESH: Disease Progression, Radiology, Biologie, Adult, medicine.medical_specialty, Allergie et immunopathologie, Immunology, Physical examination, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, Power doppler, MESH: Physical Examination, Rheumatology, Predictive Value of Tests, Humans, [SDV.BBM.BC]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Biochemistry [q-bio.BM], Physical Examination, Aged, 030203 arthritis & rheumatology, MESH: Humans, business.industry, Arthritis, Reproducibility of Results, Ultrasonography, Doppler, MESH: Adult, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, Clinical and Epidemiological Research, medicine.disease, MESH: Prospective Studies, MESH: Male, Surgery, MESH: Ultrasonography, Doppler, Joints, business, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Follow-Up Studies
Abstract

Objectives To evaluate synovitis (clinical vs ultrasound (US)) to predict structural progression in rheumatoid arthritis (RA). Methods Patients with RA. Study design Prospective, 2-year follow-up. Data collected Synovitis (32 joints (2 wrists, 10 metacarpophalangeal, 10 proximal interphalangeal, 10 metatarsophalangeal)) at baseline and after 4 months of therapy by clinical, US grey scale (GS-US) and power doppler (PD-US); x-rays at baseline and at year 2. Analysis Measures of association (OR) were tested between structural deterioration and the presence of baseline synovitis, or its persistence, after 4 months of therapy using generalised estimating equation analysis. Results Structural deterioration was observed in 9% of the 1888 evaluated joints in 59 patients. Baseline synovitis increased the risk of structural progression: OR=2.01 (1.36-2.98) p, SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2013
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2. Factors Influencing Concordance Between Clinical and Ultrasound Findings in Rheumatoid Arthritis

Author

Maria Antonietta D'Agostino, Sandrine Jousse-Joulin, Alain Saraux, Thierry Marhadour, Gérard Chalès, Jean-François Ferlet, Jérémie Sellam, Maxime Dougados, Philippe Gaudin, Isabelle Chary-Valckenaere, Fabien Etchepare, Cécile Hacquard-Bouder, Jacques Bentin, Damien Loeuille, Jean-David Albert, Christophe Hudry, Laurent Grange, Marion Le Boedec, CHRU Brest - Service de Rhumatologie (CHU - BREST - Rhumato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Statistique, RCTS, Lyon, RCTS Lyon, CHU Pontchaillou [Rennes], Clinique Universitaire de Rhumatologie, hôpital Sud, CHU de Grenoble, Assistance publique-Hôpitaux de Paris - Espace éthique (AP-HP Espace éthique), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre de Recherche Saint-Antoine (UMRS893), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de rhumatologie [Rennes] = Rheumatology [Rennes], Service de Rhumatologie, CHU Brugmann, CHU Brugmann, Belgium, Service de Rhumatologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Ambroise Paré [AP-HP], Service de rhumatologie [CHU Pitié Salpêtrière] (GRC-08 EEMOIS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], and CHU Pitié-Salpêtrière [AP-HP]

Subjects
Adult, Male, musculoskeletal diseases, medicine.medical_specialty, Pathology, Settore MED/16 - REUMATOLOGIA, Shoulders, Concordance, Immunology, Metatarsophalangeal joints, Arthritis, Rheumatoid, 03 medical and health sciences, 0302 clinical medicine, Cohen's kappa, Rheumatology, Rheumatoid, Synovitis, Internal medicine, medicine, Immunology and Allergy, Humans, 030212 general & internal medicine, Prospective Studies, Rheumatoid arthritis, [SDV.BBM.BC]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Biochemistry [q-bio.BM], Physical Examination, Aged, Ultrasonography, 030203 arthritis & rheumatology, business.industry, Tumor Necrosis Factor-alpha, Arthritis, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, Middle Aged, medicine.disease, medicine.anatomical_structure, Antirheumatic Agents, Cohort, Female, Joints, business, Kappa
Abstract

Objective.Clinical joint examination (CJE) is less time-consuming than ultrasound (US) in rheumatoid arthritis (RA). Low concordance between CJE and US would indicate that the 2 tests provide different types of information. Knowledge of factors associated with CJE/US concordance would help to select patients and joints for US. Our objective was to identify factors associated with CJE/US concordance.Methods.Seventy-six patients with RA requiring tumor necrosis factor-α (TNF-α) antagonist therapy were included in a prospective, multicenter cohort. In each patient, 38 joints were evaluated. Synovitis was scored using CJE, B-mode US (B-US), and power Doppler US (PDUS). Joints whose kappa coefficient (κ) for agreement CJE/US was < 0.1 were considered discordant. Multivariate analysis was performed to identify factors independently associated with CJE/US concordance, defined as factors yielding p < 0.05 and OR > 2.Results.Concordance before TNF-α antagonist therapy varied across joints for CJE/US (κ = −0.08 to 0.51) and B-US/PDUS (κ = 0.30 to 0.67). CJE/US concordance was low at the metatarsophalangeal joints and shoulders (κ < 0.1). Before TNF-α antagonist therapy, a low 28-joint Disease Activity Score (DAS28) was associated with good CJE/B-US concordance, and no factors were associated with CJE/PDUS concordance. After TNF-α antagonist therapy, only the joint site was associated with CJE/B-US concordance; joint site and short disease duration were associated with CJE/PDUS concordance.Conclusion.Concordance between CJE and US is poor overall. US adds information to CJE, most notably at the metatarsophalangeal joints and shoulders. Usefulness is decreased for B-US when DAS28 is low and for PDUS when disease duration is short.

Published
2013
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