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Ultrasound detected joint alterations in asymptomatic feet of RA patients
The use of ultrasound effectively detected a greater number of joint abnormalities and inflammatory changes in asymptomatic feet of patients with rheumatoid arthritis compared with controls in a recent study.
Researchers in Brazil examined and bilaterally compared foot joints in 50 patients diagnosed with rheumatoid arthritis, but with asymptomatic feet, and 50 healthy controls in a cross-sectional study. Ultrasound examinations of 22 joints per participant were conducted by a masked rheumatologist, and measurements were assessed for the presence of synovitis, synovial blood flow and bone erosion.
Greater quantitative values for synovitis were detected in all joint spaces among the RA patients (P<.003), along with the presence of synovitis (P<.035) except for the fifth tarsometatarsal (P=.118) and third metatarsophalangeal volar face (P=.059). RA patients exhibited synovitis in 18.3% of 1,800 measured joint recesses compared with 3.05% among controls (P<.001).
Power Doppler (PD) signals displayed greater frequency among study patients in the talocalcaneal (lateral window), talonavicular and dorsal faces of the first, second, third and fourth MTP joints (P=.029). Among evaluated joints, PD signals were observed in 5.77% of study patients vs. 0.22% of controls (P<.001).
Bone erosion also was significantly greater in RA patients than controls (P<.003) with the exception of the talocrural and talocalcaneal joints. Erosions were the most common ultrasound finding among patients (34.45% vs. 2.85%; P<.001).
“Greater importance should be given to rheumatoid feet, even when asymptomatic, and reinforce the importance of joint ultrasound in the detection of subclinical alteration in patients with RA,” the researchers concluded. “More studies are needed to determine what ultrasound parameters are prospectively correlated with joint damage and disease progression.”
Disclosure: The researchers report no relevant financial disclosures.