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Ultrasound demonstrates value in assessment, stratification of SLE
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According to research presented at the European League Against Rheumatism Annual European Congress of Rheumatology, ultrasound has demonstrated value in the evaluation and stratification of musculoskeletal systemic lupus erythematosus, allowing for the detection of clinically significant synovitis in patients who did not have swollen joints or were classified into British Isles Lupus Assessment Group C.
In a multicenter, cross-sectional study, researchers recruited 55 patients who met the American College of Rheumatology criteria for systemic lupus erythematosus (SLE). The researchers conducted hand ultrasound (US) examinations and clinical assessments including British Isles Lupus Assessment Group (BILAG) classification, Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), tender joint count (TJC) and swollen joint count (SJC). In addition, the researchers performed hematology and immunology assessments.
Out of the 55 patients, 18% were classified as BILAG A, 18% were classified as BILAG B, 55% were classified as BILAG C and 9% were classified as BILAG D. Results showed 58% of patients with inflammatory joint symptoms had significant ultrasound results. All patients classified with BILAG A had moderate-to-strong power Doppler signals, whereas patients classified with BILAG B did not have significant ultrasound results, according to the researchers.
The researchers found one-third of BILAG A patients had erosions. Additionally, tenosynovitis was observed in a significant number of BILAG A and C patients. On ultrasound, 16% had synovitis but did not have swollen joints.
A moderate, positive association between power Doppler and joint erosions was observed. The researchers also observed a strong positive association between ultrasound synovitis and SJC, but a weak positive association between ultrasound-detected synovitis and TJC. A moderate association was observed between ultrasound synovitis and SLEDAI.
According to the researchers, both the inflammatory markers and SLE immunological markers were not associated with joint inflammation; however, study results suggested ultrasound may be a more sensitive tool in comparison with BILAG and clinical examination. – by Monica Jaramillo
Reference:
Zayat AS, et al. Paper #FRI0569. Presented at: European League Against Rheumatism Annual European Congress of Rheumatology; June 10-13, 2015; Rome.
Disclosure: The researchers report no relevant financial disclosures.