Ultrasonography of shoulders in spondyloarthritis and rheumatoid arthritis: A case-control study |
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| Affiliation: | 1. Service de dermatologie, Centre Hospitalo-Universitaire de Strasbourg, Clinique dermatologique, 67098 Strasbourg cedex, France;2. Service de rhumatologie, centre de référence des maladies auto-immunes rares, Centre Hospitalo-Universitaire de Strasbourg, hôpital de Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France;3. Service d’immunologie, Centre Hospitalo-Universitaire de Strasbourg, hôpital de Hautepierre, Nouvel hôpital civil, 67098 Strasbourg cedex, France;4. Service de physiologie et d’explorations fonctionnelles, Centre Hospitalo-Universitaire de Strasbourg, Nouvel hôpital civil, 67098 Strasbourg cedex, France;1. Division of Rheumatology, Department of Medicine DIMED, University of Padua, Via Giustiniani 2, 35128 Padua, Italy;2. Cardiology Clinic, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy;1. Department of Radiology, West China Hospital, Sichuan University, No 37, Guoxuexiang, 610041 Chengdu, China;2. Department of Orthopaedic, West China Hospital, Sichuan University, No 37, Guoxuexiang, 610041 Chengdu, China;1. Université Paris Est Créteil, Laboratoire d’Investigation Clinique (LIC) EA4393, 94010 Créteil, France;2. AP–HP, Hôpital Henri-Mondor, Service de Rhumatologie, 51, avenue Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France;1. Service de traumatologie-orthopédie, Pavillon 32, Centre hospitalier universitaire Ibn Rochd, 1, rue des Hôpitaux, Quartier des hôpitaux, 20360 Casablanca, Morocco;2. Service de médecine physique et de réadaptation, Centre hospitalier universitaire Ibn Rochd, 1, rue des Hôpitaux, Quartier des hôpitaux, 20360 Casablanca, Morocco;1. Service de rhumatologie I, Aix Marseille université, hôpital Sainte-Marguerite, AP–HM, 13009 Marseille, France;2. Service de médecine interne, HIA Ste-Anne, 83000 Toulon, France;3. Service d’anatomopathologie, HIA Laveran, 13013 Marseille, France |
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| Abstract: | IntroductionShoulders are often involved in spondyloarthritis (SpA) and rheumatoid arthritis (RA). The diagnosis of peripheral SpA and its differential diagnosis with RA could be challenging. A recent ultrasound study showed that ultrasonography (US) of the hands might differentiate psoriatic arthritis to RA. The aim of the study was to compare different US features in SpA, RA and healthy controls.MethodsA total of 38 SpA and 43 RA patients with clinical involvement of shoulders were included and compared to 33 controls. One blinded rheumatologist performed US examinations. The following items were assessed: gleno-humeral effusion, long-head biceps tendon tenosynovitis, subacromial and subdeltoid bursitis, acromio clavicular (AC) synovitis and humeral bone erosion.ResultsThirty-eight SpA (mean age: 49.9 ± 15.4 years, 58% of male), 43 RA patients (52.9 ± 16.6 years, 26% of male) and 33 controls (55.2 ± 16.9 years, 42% of male) were assessed. In comparison to RA, SpA patients had higher frequency of AC synovitis (66% vs 5%, P < 0.0001) but lower prevalence of subacromial and subdeltoid bursitis (39% vs 67%, P = 0.015), gleno-humeral effusion (5% vs 28%, P = 0.008) and humeral bone erosion (10% vs 56%, P < 0.0001). Unilateral abnormalities were found more frequently in SpA patients than in RA (64% vs 26%, P < 0.0001).ConclusionOur results suggest that AC synovitis is highly evocative of SpA in patients with inflammatory painful shoulders. Thus, US might help to diagnose SpA and to differentiate with RA. |
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| Keywords: | Ultrasound Rheumatoid arthritis Spondyloarthritis Shoulder |
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