Structural damage in rheumatoid arthritis: comparison between tendon damage evaluated by ultrasound and radiographic damage

• Published in: Rheumatology (Oxford, England) Vol. 55; no. 6; pp. 1042 - 1046
• Main Authors: Janta, Iustina, Stanciu, Denisa, Hinojosa, Michelle, Nieto-González, Juan Carlos, Valor, Lara, Bello, Natalia, Serrano, Belen, Mata-Martínez, Carmen, Martínez-Barrio, Julia, Ovalles-Bonilla, Juan Gabriel, González, Carlos Manuel, López-Longo, Francisco Javier, Monteagudo, Indalecio, Naredo, Esperanza, Carreño, Luis
• Format: Journal Article
• Language: English
• Published: England 01.06.2016
• Subjects: Adult; Aged; Aged, 80 and over; Ankle - diagnostic imaging; Ankle - pathology; Arthritis, Rheumatoid - diagnostic imaging; Arthritis, Rheumatoid - pathology; Feasibility Studies; Female; Humans; Male; Middle Aged; Radiography - methods; Radiography - statistics & numerical data; Severity of Illness Index; Tendons - diagnostic imaging; Tendons - pathology; Ultrasonography - methods; Ultrasonography - statistics & numerical data; Wrist - diagnostic imaging; Wrist - pathology; tendon; structural damage; tendon damage; rheumatoid arthritis; ultrasound
• ISSN: 1462-0324; 1462-0332
• DOI: 10.1093/rheumatology/kew020

To compare structural damage assessed by conventional radiography and tendon damage assessed by musculoskeletal US (MSUS) at wrist and ankle in RA patients. We evaluated 72 consecutive patients [56 (77.8%) females] with RA. The MSUS evaluation consisted in a B-mode examination of bilateral extensor carpi ulnaris and tibialis posterior tendons. Tendon damage was defined and scored according to OMERACT. A total score for the tendon damage score (TDS) was calculated by summing the grades for each tendon. For the radiographic evaluations we used the van der Heijde score; a total radiographic score (RTS) was calculated by summing a bone erosion score (ERS) and a joint space narrowing score (JSNS). We evaluated 288 tendons. The mean (s.d.) of TDS was 2.3 (1.8). Fifty-four (75%) patients presented tendon damage of at least one tendon. From all evaluated tendons, 134 (46.5%) had no tendon damage, 146 (50.7%) had grade 1 and 8 (2.8%) had grade 2 tendon damage. The mean (s.d.) for RTS was 91.4 (97), for ERS was 47.3 (61.9) and for JSNS was 44.1 (37.2). We found a significant correlation between disease duration and both TDS and RTS (r = 0.413 and r = 0.560, respectively; P < 0.0001). We found a good significant correlation between TDS and all variables of radiographic structural damage (RTS, r = 0.65; ERS, r = 0.637; JSNS, r = 0.618; P < 0.001). The MSUS assessment of only four tendons can be an additional feasible method to assess structural damage in RA patients.