AB1182 THE CORRELATION BETWEEN THE ULTRASOUND-DETECTED SYNOVITIS OF SMALL JOINTS AND THE DISEASE ACTIVITY IN PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: Xiaoying Sun, Xuerong Deng, Wenhui Xie, Yu Wang, Zhuoli Zhang
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> In patients with rheumatoid arthritis (RA), small joints, especially metacarpophalangeal (MCP), and interphalangeal (PIP) joints are frequently affected. Ultrasound (US) is a sensitive method for detecting joint inflammation in patients with RA. So far, what degree does the synovitis of every small joint contribute to the disease activity in RA was not clear. <h3>Objectives</h3> The purpose of the present study was to compare the correlation between the ultrasound-detected synovitis of small joints and the disease activity in RA. <h3>Methods</h3> 211 RA patients with DAS28-ESR &gt;2.6 were included in this study. Thirty joints, including bilateral metacarpophalangeal (MCP) 1-5, proximal interphalangeal (PIP) 1-5 and metatarsophalangeal (MTP) 1-5 joints, were evaluated by ultrasound scan in all patients. Disease activity was assessed by DAS28-ESR, DAS28-CRP, CDAI, SDAI. Synovitis was detected by using semi-quantitative scoring systems (0-3) for grey scale (GS) and power Doppler (PD). All correlations among US variables and clinical variables were assessed using Spearman's rank correlation test. <h3>Results</h3> Their median age was 51.82 years, median disease duration was 60 months, with 84.3% females. The mean (SD) DAS28-ESR and DS28-CRP were 4.59±1.51 and 4.18±1.39, respectively. The whole GS scores of MCPs (MCP1-5 joints) showed highest correlation with the disease activity (r=0.403-0.452, p&lt;0.01), including DAS28-ESR, DS28-CRP, CDAI and SDAI, followed by PIPs (r=0.318-0.331, p&lt;0.01) and MTPs (r=0.277-0.301, p&lt;0.01). Similarly, the whole PD scores of MCPs also showed highest correlation with the disease activity (r=0.332-0.396, p&lt;0.01), followed by PIPs (r=0.211-0.242, p&lt;0.01), and then the least MTPs (r=0.198-0.222, p&lt;0.01). In individual joint, GS score showed better correlation with disease activity than PD score. In 30 joints, MCP3 joint exhibited the highest correlation between GS score and DAS28-ESR (r=0.411, p&lt;0.01), DAS28-CRP (r=0.459, p&lt;0.01), SDAI (r=0.444, p&lt;0.01). MCP2 joint exhibited the highest correlation between GS score and CDAI (r=0.421, p&lt;0.01). While MCP5 joint exhibited the highest correlation between PD score and DAS28-ESR (r=0.353, p&lt;0.01), DAS28-CRP (r=0.399, p&lt;0.01), CDAI (r=0.368, p&lt;0.01), SDAI (r=0.377, p&lt;0.01). In 30 joints, PIP1 showed lowest correlation between GS (r=0.166-0.199, p&lt;0.01)/PD (r=0.134-0.143, p&lt;0.01) score and disease activity. <h3>Conclusion</h3> In small joints of RA patients, the ultrasound-detected synovitis of MCPs had best correlation with disease activity, compared with PIPs and MTPs. In individual joint, MCP2, MCP3, and MCP5 joint had the best correlation between ultrasound-detected synovitis and disease activity, while PIP1 joint showed lowest correlation. <h3>References</h3> [1] Targońska-Stępniak B, Piotrowski M, Zwolak R, Majdan M. [Clinical and ultrasound assessment of the disease activity in patients with rheumatoid arthritis]. Wiad Lek. 2016;69(4):616-620. <h3>Acknowledgement</h3> The authors thank all the colleagues in our department for kind cooperation in this project and the patients for participating in this study. <h3>Disclosure of Interests</h3> None declared