POS1191-HPR ULTRASONOGRAPHIC AND FUNCTIONAL CORRELATION OF THE FEET IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

• Published in: Annals of the rheumatic diseases Vol. 82; no. Suppl 1; pp. 928 - 929
• Main Authors: L Cano Garcia, García-Campos, J, Ortiz-Márquez, F, A Reinoso Cobo, L Ramos Petersen, Marco-Lledó, J
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.06.2023
• Subjects: Ankle; Arthritis; Correlation analysis; Diagnosis; Feet; Inflammation; Joint diseases; Lupus; Quality of life; Questionnaires; Rheumatology; Synovitis; Systemic lupus erythematosus; Toe; Ultrasonic imaging; Ultrasound
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/annrheumdis-2023-eular.3167

BackgroundSystemic lupus erythematosus (SLE) is a chronic immune-mediated disease with involvement of various organs[1,2]. El 95% of patients with SLE have musculoskeletal involvement[1], most often in the form of arthralgias or non-erosive arthritis affecting mostly the hands and knees. A subgroup of patients with SLE, which is seen with increasing frequency, late develops a deforming arthropathy as a result of laxity of ligaments and peritendinous apparatus resulting in joint subluxations and tendon ruptures which is part of the accumulated damage of the disease. The foot is a heavily affected structure that may initially go unnoticed, but results in significant disability.ObjectivesTo determine the relationship between inflammatory activity measured by ultrasound in metatarsophalangeal (MTF) and questionnaires of foot functionality, hand deformities and SLE activity.MethodsA cross-sectional study was performed. Thirty-six subjects with a diagnosis of SLE in the Rheumatology Unit were consecutively recruited between March and June 2022. Inclusion criteria were: patients with SLE diagnosis according to EULAR/ACR 2019 criteria, with at least one year of evolution and age equal or older than 18 years. A Rheumatology nurse collected information on socio-demographic data, questionnaires and ultrasound scans. The SLE activity questionnaires completed were: SLEDAI and SLICC, quality of life: EQ-5D, foot function: FFI (Foot Function Index), FAAM (Foot and Ankle Ability Measures Questionnaire), FPI (Foot Posture Index). As for hand malformations collected were: Jaccoud arthropathy, non-reducible arthritis, z-finger, grommet finger, non-reducible arthritis, burst finger and gooseneck finger. A descriptive, bivariate and R-Pearson correlation analysis was performed.ResultsThirty-six SLE patients (97.2% female) with a mean (SD) age of 49.31 (11.4) years with a range 23-66 years participated. A total of 30 patients (83.3%) showed at least one MTF synovitis, the most frequent being 2nd MTF left (58.8%) and right (44.4%), followed by 1st MTF right and left (41.7%). The number of patients with and without ultrasound synovitis, as well as the degree of synovitis and Doppler signal in each joint are shown in Table 1. A significant direct correlation was observed between inflammatory activity with Doppler in the 1st MTF of the right foot with the SLICC (r=0.439; p=0.007) and SLEDAI (r=0.608; p<0.001) questionnaire; as well as an inverse relationship between synovitis in the 1st toe of the right foot with the FPI questionnaire of the right foot (r=-0.340; p=0.040) (Table 2). Likewise, a significant relationship was observed between deformity in the hands with the synovitis of 5 right (p=0.042) and left (p=0.005) MTFs.ConclusionUltrasound synovitis in MTFs is common in SLE patients and is associated with disease activity, some deformities and functionality.Table 1.Description of inflammatory activity by ultrasound in metatarsophalangeal joints of 36 patients with SLE.VariableGrade 1 SynovitisGrade 2 SynovitisGrade 3 SynovitisDoppler 1Doppler 2Rigth Foot1º MTF3(8,3%)13(36,1%)2 (5,6%)1 (2,8%)2º MTF8 (22,2%)6 (16,7%)1(2,8%)2 (5,6%)3º MTF11 (30,6%)3 (8,3%)4º MTF3 (8,3%)4 (11,1%)1 (2,8%)1 (2,8%)5º MTF7 (19,4%)Left Foot1º MTF6(16,7%)9 (25%)1 (2,8%)2º MTF10 (27,8%)9 (25%)3º MTF14 (38,9%)2 (5,6%)1 (2,8%)4º MTF3 (8,3%)6 (16,7%)1 (2,8%)5º MTF3 (8,3%)1 (2,8%)Table 2.R-Pearson correlation analysis.Doppler 1st right toeR PearsonP valueSLICC0,4390,007SLEDAI0,608<0,001Synovitis 1st right toeR PearsonP valorRigth FPI-0,3410,04References[1] Cherry L, Alcacer-Pitarch B, Hopkinson N, Teh LS, Vital EM, Edwards CJ, et al. The prevalence of self-reported lower limb and foot health problems experienced by participants with systemic lupus erythematosus: Results of a UK national survey. Lupus. 2017 Apr;26(4):410-416.[2] Durcan L, O’Dwyer T, Petri M. Management strategies and future directions for systemic lupus erythematosus in adults. Lancet. 2019 Jun 8;393(10188):2332-2343.Acknowledgements:NIL.Disclosure of InterestsNone Declared.