Ultrasound-Defined Tenosynovitis May Predict Development of Persistent Arthritis

ultrasound hand
Researchers investigated the use of ultrasound-defined tenosynovitis in predicting the persistence of inflammatory arthritis.

Ultrasound-defined tenosynovitis has demonstrated value as an independent predictor of persistent arthritis, according to study results published in Rheumatology.

Researchers assessed the ultrasound, clinical, and serologic variables that were predictive in the development of persistent inflammatory arthritis.

The multicenter study included participants with clinically diagnosed inflammatory arthritis of at least 1 joint and a symptom duration of 3 months or less. All participants were classified as disease-modifying antirheumatic drug (DMARD)-naive and were assessed for early morning stiffness duration, anticitrullinated protein/peptide antibodies (ACPA), rheumatoid factor (RF) antibodies, and other baseline characteristics.

Ultrasonographies of 16 bilateral tendon compartments and 19 bilateral joints were performed, with arthritis outcomes classified as either persistent or resolving after 18 months of follow-up.

Mann Whitney or Fisher’s exact tests were used to compare the predictive values of ultrasound-defined tenosynovitis vs synovitis, as well as serologic and clinical variables.

A total of 150 participants were included in the current analysis. At 18 months, persistent arthritis was observed in 66% (n=99) of the participants and resolving arthritis in 34% (n=51).

Using multivariate logistic regression analysis, the study researchers found that ultrasound-detected digit flexor tenosynovitis (odds ratio, 6.586 [95% CI, 1.967-22.053]; P =.002) was better able to independently predict persistence than RF antibodies and ultrasound-detected joint synovitis.

One limitation to this study was that individual flexor tendons were not scored.

The researchers concluded that, “[U]ltrasound-defined digit flexor tendon tenosynovitis is an independent predictor of persistent arthritis—even after taking into account conventional synovial ultrasound, clinical and serological variables.” They further indicated that professionals “designing scanning panels and predictive algorithms for imaging studies for persistent arthritis development should consider including digit flexor tendon as a candidate variable.”


Sahbudin I, Singh R, De Pablo P, et al. The value of ultrasound–defined tenosynovitis and synovitis in the prediction of persistent arthritis. Published online April 12, 2022. Rheumatology. doi:10.1093/rheumatology/keac199