Simplified vs modified (reduced) ultrasound 6 joint score in assessing disease activity in rheumatoid arthritis patients
DOI:
https://doi.org/10.15584/ejcem.2024.1.4Keywords:
activity, 6-joint score, rheumatoid arthritis, ultrasoundAbstract
Introduction and aim. With increasing ultrasound US assessment opportunities for tight rheumatoid arthritis (RA) management, more simplified accurate US-assessment is desired in clinical practice. Aim of the work is assessing modified vs simplified ultrasound 6-joint scores relevance in assessing rheumatoid arthritis disease activity.
Material and methods. Fifty-five RA patients were subjected to detailed history, clinical, and musculoskeletal examination with disease activity assessment by clinical disease activity index, simple disease activity index and disease activity score in 28 joints. Com plete blood count, erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor, anti-cyclic citrullinated peptide antibodies were done. Patients underwent US examination (gray-scale and power Doppler) for wrist, 2nd and 3rd metacarpophalangeal and knee joints bilaterally. Synovitis composite score was added. Two US indices were constructed: simplified S6 and modified M6 joint scores.
Results. Statistical significant positive correlations were high between S6/M6 score parameters (total, grey-scale (GS), power doppler (PD), Composite) and disease activity markers. Both M6 and S6 scores differentiated mild-moderate and moderate-severe disease activity patients. However, only S6 score differentiated remission from mild disease activity patients.
Conclusion. Ultrasound 6-joint scores (especially simplified S6) were rapid, easy and sensitive ultrasound tools assessing rheu matoid arthritis disease activity in clinical practice.
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References
Filippucci E, Cipolletta E, Mashadi Mirza R, et al. Ultrasound imaging in rheumatoid arthritis. Radiol Med. 2019;124(11):1087-1100. doi: 10.1007/s11547-019-01002-2
Gärtner M, Mandl P, Radner H, et al. Sonographic joint assessment in rheumatoid arthritis: associations with clinical joint assessment during a state of remission. Arthritis Rheum. 2013;65(8):2005-2014. doi: 10.1002/art.38016
Mandl P, Naredo E, Wakefield RJ, et al. A Systematic Literature Review Analysis of Ultrasound Joint Count and Scoring Systems to Assess Synovitis in Rheumatoid Arthritis According to the OMERACT Filter. The Journal of Rheumatology. 2011;38(9):2055-2062.
Cerqueira M, Teixeira F, Sousa Neves J, et al. Relationship between clinical evaluation and ultrasound assessment of rheumatoid arthritis patients using a 12 joint score. Int J Rheum Dis. 2017;20(7):852-858. doi: 10.1111/1756-185X.13005
Abo Gabal M, Badr Eldin A, Abd-Elmotaleb S, et al. Relationship between Clinical, Serological and Ultrasound assessment of rheumatoid arthritis activity. QJM: An International Journal of Medicine. 2023;116:hcad069.466. doi: 10.1093/qjmed/hcad069.466
Aletaha D, Neogi T, Silman AJ, et al. 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum. 2010;62(9):2569-2581. doi: 10.1002/art.27584
Aletaha D, Wang X, Zhong S, et al. Differences in disease activity measures in patients with rheumatoid arthritis who achieved DAS, SDAI, or CDAI remission but not Boolean remission. Semin Arthritis Rheum. 2020;50(2):276-284. doi: 10.1016/j.semarthrit.2020.03.022
Takanashi S, Kaneko Y, Takeuchi T. CDAI and DAS28 in the management of rheumatoid arthritis in clinical practice. Ann Rheum Dis. 2020;79(5):671-674. doi: 10.1136/annrheumdis-2019-216607
Perricone C, Ceccarelli F, Modesti M, et al. The 6-joint ultrasonographic assessment:a valid, sensitive-to-change and feasible method for evaluating joint inflammation in RA. Rheumatology (Oxford). 2012;51(5):866-873. doi: 10.1093/rheumatology/ker405
Rosa J, Ruta S, Saucedo C, Navarta DA, et al. Does a Simplified 6-Joint Ultrasound Index Correlate Well Enough With the 28-Joint Disease Activity Score to Be Used in Clinical Practice? J Clin Rheumatol. 2016;22(4):179-183. doi: 10.1097/RHU.0000000000000415
D’Agostino MA, Terslev L, Aegerter P, et al. Scoring ultrasound synovitis in rheumatoid arthritis: a EULAR-OMERACT ultrasound taskforce—Part 1: definition and development of a standardised, consensus-based scoring system. RMD Open. 2017;3:e000428. doi: 10.1136/rmdopen-2016-000428
D’Agostino MA, Wakefield RJ, Berner-Hammer H, et al. Value of ultrasonography as a marker of early response to abatacept in patients with rheumatoid arthritis and an inadequate response to methotrexate: results from the APPRAISE study. Ann Rheum Dis. 2016;75:1763-1769. doi: 10.1136/annrheumdis-2015-207709
Endo Y, Kawashiri S, Morimoto S, et al. Utility of a simplified ultrasonography scoring system among patients with rheumatoid arthritis A multicenter cohort study. Medicine. 2021;100(1):e23254. doi: 10.1097/MD.0000000000023254
El-Gohary RM, Ahmed Mahmoud AA, Khalil A, et al. Validity of 7-Joint Versus Simplified 12-Joint Ultrasonography Scoring Systems in Assessment of Rheumatoid Arthritis Activity. J Clin Rheumatol. 2019;25(6):264-271. doi: 10.1097/RHU.0000000000000847
Kamel SR, Sadek HA, Mohamed FA, et al. The ultrasound 7 score in the assessment of synovitis in rheumatoid arthritis: correlation with clinical disease activity indices. Egyptian Rheumatology & Rehabilitation. 2017;44:103-110.
Sivakumaran P, Hussain S, Attipoe L, et al. Diagnostic accuracy of simplified ultrasound hand examination protocols for detection of inflammation and disease burden in patients with rheumatoid arthritis. Acta Radiol. 2019;60(1):92-99. doi: 10.1177/0284185118773507
Figus F, Idolazzi L, Perić P, et al. Can 6 joint ultrasound score differentiate rheumatoid arthritis from psoriatic arthritis? A cross sectional study. Annals of the Rheumatic Diseases. 2020;79:1680-1681. doi: 10.1136/annrheumdis-2020-eular.6394
Dougados M, Jousse-Joulin S, Mistretta F, et al. Evaluation of several ultrasonography scoring systems for synovitis and comparison to clinical examination: results from a prospective multicentre study of rheumatoid arthritis. Ann Rheum Dis. 2010;69:828-833. doi: 10.1136/ard.2009.115493
Terslev L, Naredo E, Aegerter P, et al. Scoring ultrasound synovitis in rheumatoid arthritis: a EULAR-OMERACT ultrasound taskforce-Part 2: reliability and application to multiple joints of a standardised consensus-based scoring system. RMD Open. 2017;3(1):e000427. doi: 10.1136/rmdopen-2016-000427
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