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Ultrasound evaluation of synovitis in RA: Correlation with clinical disease activity and sensitivity to change in an observational cohort study
Institution:1. RHU/CHUV, Lausanne, Switzerland;2. Rheumatology/HUG, Geneva, Switzerland;3. Bethesda Spital AG. Basel, Switzerland;4. SCQM, Zurich, Switzerland;5. Rheumatology Inselspital, Bern, Switzerland;6. OsteoRheuma Bern, Bahnhofplatz 1, Bern, Switzerland;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. 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. 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. 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;1. Université Paris-Diderot, service de rhumatologie, hôpital Bichat, AP–HP, 46, rue Henri-Huchard, 75018 Paris, France;2. Université Paris-Diderot, service de maladies infectieuses, hôpital Bichat, AP–HP, 75018 Paris, France
Abstract:ObjectiveTo evaluate the correlation between clinical measures of disease activity and a ultrasound (US) scoring system for synovitis applied by many different ultrasonographers in a daily routine care setting within the Swiss registry for RA (SCQM) and further to determine the sensitivity to change of this US Score.MethodsOne hundred and eight Swiss rheumatologists were trained in performing the Swiss Sonography in Arthritis and Rheumatism (SONAR) score. US B-mode and Power Doppler (PwD) scores were correlated with DAS28 and compared between the clinical categories in a cross-sectional cohort of patients. In patients with a second US (longitudinal cohort), we investigated if change in US score correlated with change in DAS and evaluated the responsiveness of both methods.ResultsIn the cross-sectional cohort with 536 patients, correlation between the B-mode score and DAS28 was significant but modest (Pearson coefficient r = 0.41, P < 0.0001). The same was true for the PwD score (r = 0.41, P < 0.0001). In the longitudinal cohort with 183 patients we also found a significant correlation between change in B-mode and in PwD score with change in DAS28 (r = 0.54, P < 0.0001 and r = 0.46, P < 0.0001, respectively). Both methods of evaluation (DAS and US) showed similar responsiveness according to standardized response mean (SRM).ConclusionsThe SONAR Score is practicable and was applied by many rheumatologists in daily routine care after initial training. It demonstrates significant correlations with the degree of as well as change in disease activity as measured by DAS. On the level of the individual, the US score shows many discrepancies and overlapping results exist.
Keywords:US  Rheumatoid arthritis  Synovitis  Disease activity
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