FRI0624 U9: A NOVEL CLINICALLY ORIENTED ULTRASONOGRAPHIC SCALE FOR ASSESSING DISEASE ACTIVITY IN RHEUMATOID ARTHRITIS
Authors: Mohammed A. Mortada, Ghada Ghada, Amany Ebaid, Lobna Kotb, Youmna A. Amer
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Musculoskeletal Ultrasonography (MSUS) is now a widely used tool for the monitoring of rheumatoid arthritis (RA). Although there are many proposed sets of composite scores, a fixed set of joints may not be an ideal tool to assess a disease like RA which affects many joints and tendons in different presentations. <h3>Objectives</h3> To assess the correlation of 3 proposed ultrasonographic composite scores with disease activity indices. <h3>Methods</h3> Three different composite scores were proposed by the first author, the first score (modified U8 score) which included bilateral wrists, 2<sup>nd</sup> MCP,3<sup>RD</sup> MCP and knees which of the same set of joints proposed by Yoshimi et al 2015 with a modification of scoring of each joint according to EULAR/OMERACT combined score so the range of scores (0-24). The second score (U9) was the same of the modified U8 score plus scoring the most clinically affected joint or tendon (one joint or one tendon) so the range of score (0-27). The third proposed score (8+2) was the same of the modified U8 score plus scoring the 2 most clinically affected joint or tendon (one joint and one tendon or 2 joints or 2 tendons) so the range of score (0-30). All targeted joints were evaluated by grey-scale (GS) and power Doppler (PD) ultrasound using EULAR/OMERACT combined score (0-3). Targeted tendons were scored (0-3) by either -scale (GS) and power Doppler (PD) ultrasound and the highest score was used. One hundred and fifty four RA patients diagnosed according to ACR/EULAR criteria were recruited for the present study. A total of 154 patients with RA were included. Disease activity was assessed by clinical disease activity indices (CDAI and DAS28 ESR). Functional status was assessed by health assessment questionnaire (HAQ). <h3>Results</h3> In the cross-sectional cohort with 154 patients, correlation between the modified (U8) score and clinical disease activity parameters (CDAI and DAS28) was significant but modest (<i>r</i>=0.3, <i>P</i>=0.03 and <i>r</i>=0.4, <i>P</i>=0.01) respectively. The same was true for the (U 8+2 score) (r = 0.41, P= 0.0001, <i>r</i>=0.4, <i>P</i>=0.005). The 8+1 (U9 score) gave the best positive correlation with CDAI and DAS28 (<i>r</i>=0.7, <i>P</i>&lt;0.001, <i>r</i>=0.6, <i>P</i>&lt;0.001) respectively. HAQ was highly correlated with U9 score (<i>r</i>=0.7, <i>P</i>&lt;0.001) and moderately correlated with U8+2 score (<i>r</i>=0.3, <i>P</i>=0.05) and not correlated with the modified 8 score. <h3>Conclusion</h3> The U9 score gave the best correlation with disease activity parameters. It is simple and applicable and gives a high degree of flexibility to the sonographer according to the clinical picture. <h3>References</h3> [1] A novel 8-joint ultrasound score is useful in daily practice for rheumatoid arthritis. Modern Rheumatology25(3). DOI: 10.3109/14397595.2014.974305 <h3>Disclosure of Interests</h3> None declared