HealthDay News – A 12-joint ultrasound (US) evaluation is relevant in determining disease activity in rheumatoid arthritis patients, according to a study published online Feb. 9 in the International Journal of Rheumatic Diseases.

Marcos Cerqueira, MD, from the Hospital Conde de Bertiandos in Ponte de Lima, Portugal, and colleagues performed a 12-joint US assessment on the same day as a routine clinical assessment in 41 patients with rheumatoid arthritis on biological disease-modifying antirheumatic drug treatment.

The researchers found Grey-scale and Power Doppler >0 in 24% and 3% of the ankles, 21% and 17% of the wrists, 19% and 9% of the second metacarpophalangeal joints (MCP), 7% and 2% of the third MCP, 6 and 0 percent of the knees, and 5% and 0% of the elbows, respectively. 

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Nineteen percent of the ankles had tenosynovitis of the tibialis posterior. A US score of 0 was seen in eight of the 15 patients with Disease Activity Score of 28 joints ≤2.6. Overall, 6.7% of joints had US evidence of synovitis but were not swollen and 2.5 percent were swollen with no US evidence of synovitis.

“Using a 12 joint US assessment, a high proportion of patients with DAS28 < 2.6 were found to have inflammatory US activity, and a significant proportion of patients had evidence of tenosynovitis of the tibialis posterior, which may be difficult to clinically detect”.

“A regular and standardized US assessment of RA patients is therefore warranted to complement clinical evaluation and better define disease activity,” the authors write.

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Cerqueira M, Teixeira F, Sousa neves J, Peixoto D, Afonso MC, Costa JA. Relationship between clinical evaluation and ultrasound assessment of rheumatoid arthritis patients using a 12 joint score [published online February 9, 2017] Int J Rheum Dis. doi: 10.1111/1756-185X.13005