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Study finds 6-joint ultrasound index correlates with disease activity for patients with RA
A 6-joint ultrasound index incorporating both wrists and bilateral second and third metacarpophalangeal joints showed good correlation with the DAS28 scores and disease activity, according to recent research.
“Aside from proving useful to monitor joint inflammation in a time-consuming manner, the 6-joint score showed very good discrimination in distinguishing between disease in remission and active disease, another advantage of this shorter procedure that should be further validated in other series and that may contribute to the ‘never-ending story’ of clinical vs. imaging remission in [rheumatoid arthritis] RA,” Javier Rosa, MD, and colleagues wrote in their study.
Rosa and colleagues evaluated 60 consecutive RA patients who underwent ultrasound by a rheumatologist with ultrasound training, according to the abstract. A rheumatologist calculated the DAS28 score for each patient, with a second rheumatologist performing an ultrasound of the bilateral gray-scale and power Doppler examination of the wrist and metacarpophalangeal and proximal interphalangeal joints and creating three indices containing 22 joints (index A), 10 joints (index B) and six joints (index C).
Of the three indices, index C showed the greatest correlation with DAS28 and a moderate to high disease activity discriminatory value (DAS28 >3.2), as well as absence of remission, according to the abstract. Regarding absence of remission, there was a sensitivity of 88.89% and a specificity of 66.67% for index C with an ultrasound cutoff value of 3 points.
Overall, the researchers reported significantly higher values for all three indices for patient with active disease and there was excellent correlation between the three indices, according to the abstract. The researchers also stated the importance of the ultrasound indices and the ability of these to determine which RA patients are in clinical remission and active disease. – by Jeff Craven
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