POS1396 DAMAGE PROGRESSION OF FINGER JOINT CARTILAGE EVALUATED BY ULTRASOUND AND X-RAY IN PATIENTS WITH RHEUMATOID ARTHRITIS (RA)
Authors: T. Ogura, A. Hirata, Y. Inoue, T. Kagtagiri, Y. Takakura, H. Kameda
Journal: Annals of the Rheumatic Diseases (2021)

Background: Cartilage damage in RA has been evaluated by joint space narrowing (JSN) in X-ray, while it is not a direct evaluation of cartilage. Previously we have confirmed the usefulness of the direct imaging of finger joint cartilage by ultrasound (US) in patients with RA [1]. Objectives: We aimed to examine the temporal changes of US cartilage thickness in RA patients. Methods: We enrolled 53 RA patients in whom the cartilage thickness of finger joints was measured by US and had radiographs of both hands at baseline and 1-year later. The cartilage of metacapophalangeal and proximal interphalangeal joints of 2nd to 5th fingers were bilaterally visualized at the middle portion from a longitudinal dorsal view. Cartilage thickness was measured from the base of the cartilage to the interface artefact at the cartilage surface by static images. In addition, the JSN of the corresponding joints was scored using a hand X-ray by van der Heijde-modified Sharp method. Continuous variables from the two groups were analyzed using the Mann-Whitney U test or Wilcoxon signed-rank test. The relationships among the continuous variables were assessed using the Spearman’s rank correlation coefficient. Results: The median age of the patients was 68 years and the median disease duration was 6.3 years. The sum of total cartilage thickness from 16 joints per patient ranged from 3.1 to 9.1mm (median 6.5 mm) at baseline, and it was significantly correlated with total JSN score of the same joints (ρ=-0.63, p&lt;0.001). The cartilage thickness was inversely correlated with disease duration (rho=-0.40, p=0.003), but not associated with age nor height. The decrease in cartilage thickness over 1 year was evident in patients with persistent moderate to high disease activity by the DAS28-CRP (n=10; median -6.2%) as compared with other patients (n=43; median -1.2%, p=0.004 versus active patients). Conclusion: This pilot study demonstrated the progression of cartilage damage by sustained RA activity, supporting the validity and usefulness of joint cartilage thickness evaluation by ultrasound in patients with RA. References: [1]Ogura T, et al. Arthritis Care Res 2019 Oct 25. Table 1. SALIENT FEATURES OF THE 9 PATIENTS PRESENTING WITH RETINAL TOXICITY DUE TO HCQ Sl.No Age Gender Weight (Kg) Primary Diagnosis Dose Duration (Years) Detection Method Used Recommended Dose (mg/Day) Received Dose (mg/Day) Cumulative Dose (grams) FUNDUS EXAM. SD-OCT HVF 10-2 F AF 1 47 F 58 SLE 290 400 438 3 RPE Changes Thinning/Photoreceptor Loss Defects seen - 2 20 F 46 SLE 230 200 146 2 Multiple Small Drusens In Paramacular Area Multiple Drusens Normal Perifoveal autofluorescence spots- drusens 3 23 F 50 SLE 250 400 146 1 RPE Changes RPE Disruptions Defects seen - 4 30 F 55 SLE 275 200 73 1 Normal Normal Paracentral Scotoma - 5 50 F 49 RA 245 200 511 7 Early Bull’s Eye Maculopathy RPE Atrophy Defects seen - 6 72 F 60 RA 300 200 730 10 RPE Atrophy FR Absent RPE Atrophy General reduction in sensitivity - 7 65 M 57.4 RA 287 200 146 2 RPE Changes RPE Disruptions &amp; Thinning Noted Defects seen - 8 62 F 70 RA 350 200 219 3 Chorioretinal Atrophy Altered RPE Membrane Defects seen - 9 59 M 71.6 RA 358 200 292 4 RPE Changes RPE Disruptions Normal - F:Female; M:Male; SLE:Systemic Lupus Erythematosus; RA: Rheumatoid Arthritis, FUNDUS EXAM.: Fundus Examination; SD-OCT:Spectral Domain-Optical Coherence Tomography, HVF 10-2:Humphrey Visual Field 10-2; FAF: Fundus Autofluorescence, RPE:Retinal Pigment Epithelium; FR:Foveal Reflex Disclosure of Interests: None declared