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Ultrasound-detected tenosynovitis independently associates with patient-reported flare in patients with rheumatoid arthritis in clinical remission: results from the observational study STARTER of the Italian Society for Rheumatology.
- Source :
-
Rheumatology (Oxford, England) [Rheumatology (Oxford)] 2016 Oct; Vol. 55 (10), pp. 1826-36. Date of Electronic Publication: 2016 Jun 27. - Publication Year :
- 2016
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Abstract
- Objectives: This study aimed to estimate the prevalence of US-detected tenosynovitis in RA patients in clinical remission and to explore its clinical correlates.<br />Methods: A total of 427 RA patients in clinical remission were consecutively enrolled from 25 Italian rheumatology centres. Tenosynovitis and synovitis were scored by US grey scale (GS) and power Doppler (PD) semi-quantitative scoring systems at wrist and hand joints. Complete clinical assessment was performed by rheumatologists blinded to the US results. A flare questionnaire was used to assess unstable remission (primary outcome), HAQ for functional disability and radiographic erosions for damage (secondary outcomes). Cross-sectional relationships between the presence of each US finding and outcome variables are presented as odds ratios (ORs) and 95% CIs, both crude and adjusted for pre-specified confounders.<br />Results: The prevalence of tenosynovitis in clinical remission was 52.5% (95% CI 0.48, 0.57) for GS and 22.7% (95% CI 0.19, 0.27) for PD, while the prevalence of synovitis was 71.6% (95% CI 0.67, 0.76) for GS and 42% (95% CI 0.37, 0.47) for PD. Among clinical correlates, PD tenosynovitis associated with lower remission duration and morning stiffness while PD synovitis did not. Only PD tenosynovitis showed a significant association with the flare questionnaire [OR 1.95 (95% CI 1.17, 3.26)]. No cross-sectional associations were found with the HAQ. The presence of radiographic erosions associated with GS and PD synovitis but not with tenosynovitis.<br />Conclusions: US-detected tenosynovitis is a frequent finding in RA patients in clinical remission and associates with unstable remission.<br /> (© The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)
- Subjects :
- Adolescent
Adult
Age Distribution
Aged
Arthritis, Rheumatoid complications
Arthritis, Rheumatoid epidemiology
Cross-Sectional Studies
Female
Humans
Italy epidemiology
Male
Middle Aged
Prevalence
Synovitis complications
Synovitis diagnostic imaging
Synovitis epidemiology
Tenosynovitis complications
Tenosynovitis epidemiology
Ultrasonography, Doppler
Young Adult
Arthritis, Rheumatoid diagnostic imaging
Tenosynovitis diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1462-0332
- Volume :
- 55
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Rheumatology (Oxford, England)
- Publication Type :
- Academic Journal
- Accession number :
- 27354688
- Full Text :
- https://doi.org/10.1093/rheumatology/kew258