Ultrasonography of articular and periarticular structures as a relapse predictor in patients with clinically remitted rheumatoid arthritis

Introduction: Rheumatoid arthritis (RA) is an autoimmune disease causing mortality and morbidity among patients. The goal of RA treatment is remission and prevention of joint degeneration. Remission is diagnosed by physical examinations and laboratory markers. Due to the high rate of relapse, it app...

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Main Authors: Mehdi Karami, Zohre Mohammadzadeh, Shadi Ebrahimian, Maryam Moradi, Sayedbonakdar Zahra
Format: Article
Language:English
Published: SAGE Publishing 2020-01-01
Series:Indian Journal of Rheumatology
Subjects:
Online Access:http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2020;volume=15;issue=1;spage=17;epage=22;aulast=Karami
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author Mehdi Karami
Zohre Mohammadzadeh
Shadi Ebrahimian
Maryam Moradi
Sayedbonakdar Zahra
author_facet Mehdi Karami
Zohre Mohammadzadeh
Shadi Ebrahimian
Maryam Moradi
Sayedbonakdar Zahra
author_sort Mehdi Karami
collection DOAJ
description Introduction: Rheumatoid arthritis (RA) is an autoimmune disease causing mortality and morbidity among patients. The goal of RA treatment is remission and prevention of joint degeneration. Remission is diagnosed by physical examinations and laboratory markers. Due to the high rate of relapse, it appears that physical examination is not a sensitive method in detecting active and remitted RA patients. The aim of this study is to find whether ultrasonography (US) is an appropriate method in detecting active RA patients and estimating the relapse rate. Methods: Seventy clinically remitted RA patients were enrolled based on the Disease Activity Score in 28 joints. They underwent US to examine the presence of synovitis, tendinitis, tenosynovitis, and bursitis and were followed for 6 months regarding the relapse rate. Moreover, the predictive value of US was measured. SPSS was used for analyzing data. Results: According to the US findings, 27.1% of the clinically remitted patients had signs of active synovitis, whereas 15.7% of them showed signs of tenosynovitis, tendinitis, or bursitis. In addition, relapse was observed in 12.9% of the patients with clinical remission and was significantly higher in patients with signs of active synovitis (P < 0.05). The results also revealed that the prognostic values of US for estimating the relapse rate were 77.7% and 70.0% in terms of sensitivity and specificity, respectively. Conclusions: US is capable of detecting active synovitis among patients with clinically remitted RA and also predicts those with a higher risk of relapse within 6 months. It is also useful in identifying people with active RA, whose clinical symptoms indicate remission of the disease. Involvement of periarticular structures including tenosynovitis, tendinitis, or bursitis cannot independently predict relapse in patients with RA.
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spelling doaj-art-486af3afe5af406ebaac7b7521d5fd2a2025-02-03T11:42:55ZengSAGE PublishingIndian Journal of Rheumatology0973-36980973-37012020-01-01151172210.4103/injr.injr_103_19Ultrasonography of articular and periarticular structures as a relapse predictor in patients with clinically remitted rheumatoid arthritisMehdi KaramiZohre MohammadzadehShadi EbrahimianMaryam MoradiSayedbonakdar ZahraIntroduction: Rheumatoid arthritis (RA) is an autoimmune disease causing mortality and morbidity among patients. The goal of RA treatment is remission and prevention of joint degeneration. Remission is diagnosed by physical examinations and laboratory markers. Due to the high rate of relapse, it appears that physical examination is not a sensitive method in detecting active and remitted RA patients. The aim of this study is to find whether ultrasonography (US) is an appropriate method in detecting active RA patients and estimating the relapse rate. Methods: Seventy clinically remitted RA patients were enrolled based on the Disease Activity Score in 28 joints. They underwent US to examine the presence of synovitis, tendinitis, tenosynovitis, and bursitis and were followed for 6 months regarding the relapse rate. Moreover, the predictive value of US was measured. SPSS was used for analyzing data. Results: According to the US findings, 27.1% of the clinically remitted patients had signs of active synovitis, whereas 15.7% of them showed signs of tenosynovitis, tendinitis, or bursitis. In addition, relapse was observed in 12.9% of the patients with clinical remission and was significantly higher in patients with signs of active synovitis (P < 0.05). The results also revealed that the prognostic values of US for estimating the relapse rate were 77.7% and 70.0% in terms of sensitivity and specificity, respectively. Conclusions: US is capable of detecting active synovitis among patients with clinically remitted RA and also predicts those with a higher risk of relapse within 6 months. It is also useful in identifying people with active RA, whose clinical symptoms indicate remission of the disease. Involvement of periarticular structures including tenosynovitis, tendinitis, or bursitis cannot independently predict relapse in patients with RA.http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2020;volume=15;issue=1;spage=17;epage=22;aulast=Karamiarthritisdopplerrheumatoidultrasonography
spellingShingle Mehdi Karami
Zohre Mohammadzadeh
Shadi Ebrahimian
Maryam Moradi
Sayedbonakdar Zahra
Ultrasonography of articular and periarticular structures as a relapse predictor in patients with clinically remitted rheumatoid arthritis
Indian Journal of Rheumatology
arthritis
doppler
rheumatoid
ultrasonography
title Ultrasonography of articular and periarticular structures as a relapse predictor in patients with clinically remitted rheumatoid arthritis
title_full Ultrasonography of articular and periarticular structures as a relapse predictor in patients with clinically remitted rheumatoid arthritis
title_fullStr Ultrasonography of articular and periarticular structures as a relapse predictor in patients with clinically remitted rheumatoid arthritis
title_full_unstemmed Ultrasonography of articular and periarticular structures as a relapse predictor in patients with clinically remitted rheumatoid arthritis
title_short Ultrasonography of articular and periarticular structures as a relapse predictor in patients with clinically remitted rheumatoid arthritis
title_sort ultrasonography of articular and periarticular structures as a relapse predictor in patients with clinically remitted rheumatoid arthritis
topic arthritis
doppler
rheumatoid
ultrasonography
url http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2020;volume=15;issue=1;spage=17;epage=22;aulast=Karami
work_keys_str_mv AT mehdikarami ultrasonographyofarticularandperiarticularstructuresasarelapsepredictorinpatientswithclinicallyremittedrheumatoidarthritis
AT zohremohammadzadeh ultrasonographyofarticularandperiarticularstructuresasarelapsepredictorinpatientswithclinicallyremittedrheumatoidarthritis
AT shadiebrahimian ultrasonographyofarticularandperiarticularstructuresasarelapsepredictorinpatientswithclinicallyremittedrheumatoidarthritis
AT maryammoradi ultrasonographyofarticularandperiarticularstructuresasarelapsepredictorinpatientswithclinicallyremittedrheumatoidarthritis
AT sayedbonakdarzahra ultrasonographyofarticularandperiarticularstructuresasarelapsepredictorinpatientswithclinicallyremittedrheumatoidarthritis