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Li Y, Zhang Z, Liu C, Kang Z, Li Z. Significance of High-Frequency Sonography for the Subclinical Progression of Rheumatoid Arthritis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:1509-1520. [PMID: 38720412 DOI: 10.1002/jum.16474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 04/19/2024] [Accepted: 04/21/2024] [Indexed: 07/14/2024]
Abstract
OBJECTIVES This study aims to investigate the use of high-frequency sonography as a tool for detecting inflammatory and destructive changes in the hand and foot joints of patients with early and long-term RA. METHODS This study employs a prospective cohort design involving 162 patients diagnosed with Rheumatoid arthritis (RA) who meet the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria. Patients were divided into two groups based on disease duration: Group 1 (n = 74) included patients with a disease duration of up to 2 years, or early РА (ERA;), Group 2 (n = 88) consisted of patients with a disease duration exceeding 2 years, or long-term persistent РА (LtRA). All patients underwent a clinical assessment of their joints, as well as radiography and arthrosonography, at the beginning of the study and again at 6 and 12 months later. RESULTS In the general group of patients, ultrasound examination revealed signs of synovitis in the joints of the hands more frequently (66%) compared with clinical examination (56% by a number of swollen joints [NSJ] and 55% by a number of painful joints [NPJ], P < .01). After 6 months of treatment, 12% of the patients achieved full US remission and 24% achieved partial US remission. CONCLUSIONS Within the scope of comprehensive RA diagnostics, arthrosonography of the joints of the hands and feet, utilizing a combination of greyscale and power Doppler, may surpass radiography in detecting early RA. This method allows for a more accurate assessment of disease activity and progression rates.
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Affiliation(s)
- Yudan Li
- Ultrasonography Division, Shenzhen Third People's Hospital, The Second Affiliated Hospital, Southern University of Science and Technology, Shenzhen, China
| | - Ziteng Zhang
- Hepato-Biliary Surgery Division, Shenzhen Third People's Hospital, The Second Affiliated Hospital, Southern University of Science and Technology, Shenzhen, China
| | - Cuicui Liu
- Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhilong Kang
- Hepato-Biliary Surgery Division, Shenzhen Third People's Hospital, The Second Affiliated Hospital, Southern University of Science and Technology, Shenzhen, China
| | - Zhiyan Li
- Ultrasonography Division, Shenzhen Third People's Hospital, The Second Affiliated Hospital, Southern University of Science and Technology, Shenzhen, China
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Ebadati S, Sahebari M, Ahmadzadeh AM, Emadzadeh M, Khoroushi F, Ragati Haghi H, Giti R, Aminzadeh B. Correlation of US-7 and US-9 Scores with Disease Activity Score using 28 Joint Counts (DAS28) in Patients with Rheumatoid Arthritis. IRANIAN JOURNAL OF MEDICAL SCIENCES 2024; 49:167-175. [PMID: 38584648 PMCID: PMC10997851 DOI: 10.30476/ijms.2023.97776.2996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 04/30/2023] [Accepted: 05/31/2023] [Indexed: 04/09/2024]
Abstract
Background The attentive management of rheumatoid arthritis (RA) has attracted particular attention. The German 7-joint Ultrasound (US-7) is the first scoring system that combines bone erosions and soft tissue lesions in a single composite scoring system. This study aimed to assess the correlation between US-7 and Disease Activity Score Using 28 Joint Counts (DAS28) in clinically active RA patients. The efficacy of a novel ultrasound score-based system, the US-9 score (joints assessed with US-7 plus knees), was also compared with the standard US-7 score. Methods All the RA patients referred to the outpatient rheumatology clinic of Ghaem Hospital, Mashhad, Iran, during 2019-2020 were included. 28 joints were clinically examined to calculate DAS28. Nine joints were assessed comprising the German US-7 plus knees using grayscale ultrasonography (GSUS) and power Doppler ultrasonography (PDUS). Retrieved data were analyzed by SPSS software, version 22. The Spearman Correlation test was used to find the correlation between DAS28 and ultrasonographic findings. The statistical significance level was set at P<0.05. Results This study was composed of thirty-five RA patients with a mean age of 49.1±12.0 years. US-7 synovitis scores in GSUS and PDUS were significantly correlated with DAS28 (P=0.02, r=0.38 and P=0.003, r=0.48, respectively). US-9 synovitis scores in GSUS and PDUS were also significantly correlated with DAS28 (P=0.003, r=0.49 and P=0.006, r=0.45, respectively). The synovitis score measured by GSUS was significantly correlated with the GSUS knee synovial score (P=0.01, r=0.42). Conclusion Ultrasound assessment of large joints such as knees can be an effective approach to determining RA severity. However, it can be proposed that adding more involved joints into the sonographic assessment does not necessarily provide a better clinical correlation.
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Affiliation(s)
- Sahar Ebadati
- Department of Radiology, Medical Imaging Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Sahebari
- Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Mahmoud Ahmadzadeh
- Transplant Research Center, Clinical Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Emadzadeh
- Clinical Research Development Unit, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farzaneh Khoroushi
- Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hedieh Ragati Haghi
- Department of Radiology, Brigham and Women's Hospital, Boston, MA 02215, USA
| | - Ramesh Giti
- Department of Radiology, Medical Imaging Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Behzad Aminzadeh
- Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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3
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Zhao Q, Ren H, Yang N, Xia X, Chen Q, Zhou D, Liu Z, Chen X, Chen Y, Huang W, Zhou H, Xu H, Zhang W. Bifidobacterium pseudocatenulatum-Mediated Bile Acid Metabolism to Prevent Rheumatoid Arthritis via the Gut-Joint Axis. Nutrients 2023; 15:nu15020255. [PMID: 36678126 PMCID: PMC9861548 DOI: 10.3390/nu15020255] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/27/2022] [Accepted: 12/28/2022] [Indexed: 01/06/2023] Open
Abstract
Early intervention in rheumatoid arthritis (RA) is critical for optimal treatment, but initiation of pharmacotherapy to prevent damage remains unsatisfactory currently. Manipulation of the gut microbiome and microbial metabolites can be effective in protecting against RA. Thus, probiotics can be utilized to explore new strategies for preventing joint damage. The aim of this study was to explore the metabolites and mechanisms by which Bifidobacterium pseudocatenulatum affects RA. Based on 16S rRNA sequencing and UPLC-MS/MS assays, we focused on bile acid (BA) metabolism. In a collagen-induced arthritis (CIA) mouse model, B. pseudocatenulatum prevented joint damage by protecting the intestinal barrier and reshaped gut microbial composition, thereby elevating bile salt hydrolase (BSH) enzyme activity and increasing the levels of unconjugated secondary BAs to suppress aberrant T-helper 1/17-type immune responses; however, these benefits were eliminated by the Takeda G protein-coupled receptor 5 (TGR5) antagonist SBI-115. The results suggested that a single bacterium, B. pseudocatenulatum, can prevent RA, indicating that prophylactic administration of probiotics may be an effective therapy.
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Affiliation(s)
- Qing Zhao
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha 410008, China
- Hunan Key Laboratory of Pharmacogenetics, Institute of Clinical Pharmacology, Central South University, 110 Xiangya Road, Changsha 410078, China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha 410078, China
- National Clinical Research Center for Geriatric Disorders, 87 Xiangya Road, Changsha 410008, China
| | - Huan Ren
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha 410008, China
- Hunan Key Laboratory of Pharmacogenetics, Institute of Clinical Pharmacology, Central South University, 110 Xiangya Road, Changsha 410078, China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha 410078, China
- National Clinical Research Center for Geriatric Disorders, 87 Xiangya Road, Changsha 410008, China
| | - Nian Yang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha 410008, China
- Hunan Key Laboratory of Pharmacogenetics, Institute of Clinical Pharmacology, Central South University, 110 Xiangya Road, Changsha 410078, China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha 410078, China
- National Clinical Research Center for Geriatric Disorders, 87 Xiangya Road, Changsha 410008, China
| | - Xuyang Xia
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Qifeng Chen
- Department of Pathology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha 410008, China
| | - Dingding Zhou
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha 410008, China
- Hunan Key Laboratory of Pharmacogenetics, Institute of Clinical Pharmacology, Central South University, 110 Xiangya Road, Changsha 410078, China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha 410078, China
- National Clinical Research Center for Geriatric Disorders, 87 Xiangya Road, Changsha 410008, China
| | - Zhaoqian Liu
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha 410008, China
- Hunan Key Laboratory of Pharmacogenetics, Institute of Clinical Pharmacology, Central South University, 110 Xiangya Road, Changsha 410078, China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha 410078, China
- National Clinical Research Center for Geriatric Disorders, 87 Xiangya Road, Changsha 410008, China
| | - Xiaoping Chen
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha 410008, China
- Hunan Key Laboratory of Pharmacogenetics, Institute of Clinical Pharmacology, Central South University, 110 Xiangya Road, Changsha 410078, China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha 410078, China
- National Clinical Research Center for Geriatric Disorders, 87 Xiangya Road, Changsha 410008, China
| | - Yao Chen
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha 410008, China
- Hunan Key Laboratory of Pharmacogenetics, Institute of Clinical Pharmacology, Central South University, 110 Xiangya Road, Changsha 410078, China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha 410078, China
- National Clinical Research Center for Geriatric Disorders, 87 Xiangya Road, Changsha 410008, China
| | - Weihua Huang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha 410008, China
- Hunan Key Laboratory of Pharmacogenetics, Institute of Clinical Pharmacology, Central South University, 110 Xiangya Road, Changsha 410078, China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha 410078, China
- National Clinical Research Center for Geriatric Disorders, 87 Xiangya Road, Changsha 410008, China
| | - Honghao Zhou
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha 410008, China
- Hunan Key Laboratory of Pharmacogenetics, Institute of Clinical Pharmacology, Central South University, 110 Xiangya Road, Changsha 410078, China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha 410078, China
- National Clinical Research Center for Geriatric Disorders, 87 Xiangya Road, Changsha 410008, China
| | - Heng Xu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Wei Zhang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha 410008, China
- Hunan Key Laboratory of Pharmacogenetics, Institute of Clinical Pharmacology, Central South University, 110 Xiangya Road, Changsha 410078, China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha 410078, China
- National Clinical Research Center for Geriatric Disorders, 87 Xiangya Road, Changsha 410008, China
- Correspondence: ; Tel.: +86-731-84805380
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Ishie S, Ito H, Nakabo S, Tsuji H, Nakajima T, Tsuji Y, Inagaki M, Furu M, Hashimoto M, Murata K, Murakami K, Nishitani K, Tanaka M, Fujii Y, Matsuda S. Region specificity of rheumatoid foot symptoms associated with ultrasound-detected synovitis and joint destruction. Mod Rheumatol 2022; 32:127-135. [PMID: 33851898 DOI: 10.1080/14397595.2021.1912905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/28/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES We aimed to clarify the clinical implication of ultrasound (US)-detected foot joint inflammation in tightly controlled patients with rheumatoid arthritis (RA). METHODS We evaluated bilateral foot joints (second to fifth metatarsophalangeal joints of forefoot; tarsometatarsal, cuneonavicular and midtarsal joints of midfoot) of 430 RA patients for synovitis using Power Doppler (PD) imaging by US. We made a cross-sectional and a 3-year longitudinal analysis about the associations of US-detected synovitis with clinical, laboratory and radiographic data as well as foot-specific outcomes using a self-administered foot evaluation questionnaire (SAFE-Q). RESULTS The US-detected foot synovitis was seen in 28% of patients. The US-detected synovitis was closely related to 28 joint-disease activity score (DAS28) more in the forefoot than in the midfoot, while related to joint destruction in both. Multiple regression analyses showed significant associations between midfoot PD positivity and SAFE-Q in the remission group. SAFE-Q was worsened after the 3-year interval, but PD positivity at baseline did not contribute to the changes. On the other hand, destruction of the joints with US-detected synovitis significantly progressed in 3 years than with not. CONCLUSIONS US-detected synovitis on foot joints were related to systemic inflammation, clinical symptoms, and future joint destruction with region specificity.
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Affiliation(s)
- Shinichiro Ishie
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiromu Ito
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Advanced Medicine for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shuichiro Nakabo
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hideaki Tsuji
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Toshiki Nakajima
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yuko Tsuji
- Department of Human Health Science, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Maiko Inagaki
- Department of Human Health Science, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Moritoshi Furu
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Advanced Medicine for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Motomu Hashimoto
- Department of Advanced Medicine for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Koichi Murata
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Advanced Medicine for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kosaku Murakami
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kohei Nishitani
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masao Tanaka
- Department of Advanced Medicine for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yasutomo Fujii
- Department of Human Health Science, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shuichi Matsuda
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
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5
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Wen J, Liu J, Xin L, Wan L, Jiang H, Sun Y, Sun Y, Wang X, Wang J. Effective factors on Sharp Score in patients with rheumatoid arthritis: a retrospective study. BMC Musculoskelet Disord 2021; 22:865. [PMID: 34627206 PMCID: PMC8502366 DOI: 10.1186/s12891-021-04742-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 09/27/2021] [Indexed: 02/07/2023] Open
Abstract
Background This study aims to describe the association between sharp score and clinical indexes, bone metabolism indexes, Disease Activity Score (DAS28) and sociodemographic factors in rheumatoid arthritis (RA). Methods Data were collected from the HIS (hospital information system), a national inpatient database in China, with information on the patients hospitalized during the period from 2012 to 2019. The association between sharp score and effective factors were identified using multinomial logistic regression and association rule mining (ARM). Results Three thousand eight hundred and forty patients were included: 82.66% males, 17.34% females, mean (SD) age 56.95 (12.68) years and symptom duration 3.45 (1.09) years. Spearman correlation analysis and Association rules analysis showed that there were significant positive correlations between sharp score and effective factors. Logistic regression analysis presented that erythrocyte sedimentation rate (ESR), high-sensitivity C-reactive protein (CRP), rheumatoid factor (RF) were risk factors of sharp score. In the analysis of individual outcomes, sex, age, symptom duration, DSA28 score, RF, ever drinker, and radiographic grading of hands were influence factors of sharp score. Conclusion Sharp score should be taken into consideration in formulating treatment strategies in RA.
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Affiliation(s)
- Jianting Wen
- Anhui University of Traditional Chinese Medicine, Hefei, 230031, Anhui Province, China.,Department of Rheumatology and Immunology, First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, 230038, Anhui Province, China.,Institute of Rheumatology, Anhui College of Traditional Chinese Medicine, Hefei, 230038, Anhui Province, China.,Key Laboratory of Xin'an Medicine of the Ministry of Education, Anhui University of Chinese Medicine, Hefei, Anhui, 230038, P. R. China.,Anhui Province Key Laboratory of Modern Chinese Medicine Department of Internal Medicine Application Foundation Research and Development, Hefei, 230031, Anhui, China
| | - Jian Liu
- Department of Rheumatology and Immunology, First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, 230038, Anhui Province, China. .,Institute of Rheumatology, Anhui College of Traditional Chinese Medicine, Hefei, 230038, Anhui Province, China. .,Key Laboratory of Xin'an Medicine of the Ministry of Education, Anhui University of Chinese Medicine, Hefei, Anhui, 230038, P. R. China. .,Anhui Province Key Laboratory of Modern Chinese Medicine Department of Internal Medicine Application Foundation Research and Development, Hefei, 230031, Anhui, China.
| | - Ling Xin
- Department of Rheumatology and Immunology, First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, 230038, Anhui Province, China.,Institute of Rheumatology, Anhui College of Traditional Chinese Medicine, Hefei, 230038, Anhui Province, China.,Anhui Province Key Laboratory of Modern Chinese Medicine Department of Internal Medicine Application Foundation Research and Development, Hefei, 230031, Anhui, China
| | - Lei Wan
- Department of Rheumatology and Immunology, First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, 230038, Anhui Province, China.,Institute of Rheumatology, Anhui College of Traditional Chinese Medicine, Hefei, 230038, Anhui Province, China.,Anhui Province Key Laboratory of Modern Chinese Medicine Department of Internal Medicine Application Foundation Research and Development, Hefei, 230031, Anhui, China
| | - Hui Jiang
- Department of Rheumatology and Immunology, First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, 230038, Anhui Province, China.,Institute of Rheumatology, Anhui College of Traditional Chinese Medicine, Hefei, 230038, Anhui Province, China.,Anhui Province Key Laboratory of Modern Chinese Medicine Department of Internal Medicine Application Foundation Research and Development, Hefei, 230031, Anhui, China
| | - Yue Sun
- Department of Rheumatology and Immunology, First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, 230038, Anhui Province, China.,Institute of Rheumatology, Anhui College of Traditional Chinese Medicine, Hefei, 230038, Anhui Province, China.,Anhui Province Key Laboratory of Modern Chinese Medicine Department of Internal Medicine Application Foundation Research and Development, Hefei, 230031, Anhui, China
| | - Yanqiu Sun
- Anhui University of Traditional Chinese Medicine, Hefei, 230031, Anhui Province, China.,Anhui Province Key Laboratory of Modern Chinese Medicine Department of Internal Medicine Application Foundation Research and Development, Hefei, 230031, Anhui, China
| | - Xin Wang
- Anhui University of Traditional Chinese Medicine, Hefei, 230031, Anhui Province, China.,Anhui Province Key Laboratory of Modern Chinese Medicine Department of Internal Medicine Application Foundation Research and Development, Hefei, 230031, Anhui, China
| | - Jie Wang
- Anhui University of Traditional Chinese Medicine, Hefei, 230031, Anhui Province, China.,Anhui Province Key Laboratory of Modern Chinese Medicine Department of Internal Medicine Application Foundation Research and Development, Hefei, 230031, Anhui, China
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6
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Wang C, Qin Y, Xu J, Li G, Lei J, Zhang C, Deng H. Correlation of Ultrasound Synovitis Joint Count with Disease Activity and Its Longitudinal Variation with Treatment Response to Etanercept in Rheumatoid Arthritis. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:2543-2549. [PMID: 34175145 DOI: 10.1016/j.ultrasmedbio.2021.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/26/2021] [Accepted: 05/06/2021] [Indexed: 06/13/2023]
Abstract
More research is needed into rheumatoid arthritis (RA), and ultrasound (US) synovitis is a promising factor for assisting in the management of RA; however, related research is extremely limited. The goal of this study was to evaluate the correlation of US synovitis joint count with clinical features, and its longitudinal changes with treatment response to etanercept in RA. We consecutively enrolled 117 people with active RA being treated with etanercept. US synovitis joint count was evaluated in 28 joints at baseline (W0), week 4 (W4), week 12 (W12) and week 24 (W24) after initiation of etanercept treatment. The mean (±standard deviation), median, inter-quartile range, and total range of the US synovitis joint count at W0 were 9.3 ± 4.0, 9.0, 7.0-11.0 and 2.0-21.0, respectively. US synovitis joint count was positively associated with tenderness joint count, swollen joint count, erythrocyte sedimentation rate, 28-joint Disease Activity Score based on erythrocyte sedimentation rate and Health Assessment Questionnaire-Disability Index score. Then participants were categorized into response and non-response groups according to their response status at W24. Further analyses showed that US synovitis joint count gradually decreased from W0 to W24, and displayed a more notable declining trend in the response group compared with the non-response group. In addition, US synovitis joint count at W0 and W4 was similar between groups, but at W12 and W24 it was markedly decreased in the response group compared with the non-response group. In conclusion, US synovitis joint count correlates with disease activity, and its longitudinal decrease is associated with treatment response to etanercept in RA.
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Affiliation(s)
- Chaojun Wang
- Department of Ultrasound, Lishui People's Hospital, Lishui, China
| | - Yong Qin
- Department of General Surgery, Lishui People's Hospital, Lishui, China
| | - Jinghua Xu
- Department of Ultrasound, Lishui People's Hospital, Lishui, China
| | - Gang Li
- Department of Ultrasound, Lishui People's Hospital, Lishui, China
| | - Jianming Lei
- Department of Ultrasound, Lishui People's Hospital, Lishui, China
| | - Chunlai Zhang
- Department of Ultrasound, Lishui People's Hospital, Lishui, China
| | - Huadong Deng
- Department of Ultrasound, Lishui People's Hospital, Lishui, China.
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7
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Safar AH, Zaki MG, Al-Zifzaf DS, El-Hilaly RA, Abaza N. Value of musculoskeletal ultrasound in assessment of rheumatoid hand function. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2020. [DOI: 10.1186/s43055-020-00327-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Musculoskeletal ultrasound can be now considered a complement to physical examination in rheumatoid arthritis. This study evaluates the role of musculoskeletal ultrasound in assessment of rheumatoid hand function and underlying functional defects and disabilities in order to find out a possibly better tool for assessment.
Results
Hand grip weakness was significantly associated with metacarpophalangeal joints synovitis of ulnar 4 fingers (p = 0.045), wrist joint synovitis (p = 0.009), flexor tendons tenosynovitis of the ulnar 4 fingers (p = 0.001), flexor pollicis longus tendon tenosynovitis (p = 0.013).
Hand function impairment by grip ability test was significantly associated with metacarpophalangeal joints synovitis of ulnar 4 fingers (p = 0.009), wrist joint synovitis (p = 0.004), and flexor tendons tenosynovitis of the ulnar 4 fingers (p = 0.042). Multiple linear regression analysis showed that the most influencing factor affecting grip ability test and hand grip strength was ulnar 4 Flexor tendons tenosynovitis (P = 0.023, P = 0.037) respectively.
Conclusions
Joint synovitis and tenosynovitis that are detected by musculoskeletal ultrasound can be used as an assessment tool for hand function in rheumatoid arthritis, since they are associated with reduced hand grip strength and impaired hand ability.
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8
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Mandl P, Aletaha D. The role of ultrasound and magnetic resonance imaging for treat to target in rheumatoid arthritis and psoriatic arthritis. Rheumatology (Oxford) 2020; 58:2091-2098. [PMID: 31518423 DOI: 10.1093/rheumatology/kez397] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 08/04/2019] [Accepted: 08/07/2019] [Indexed: 01/04/2023] Open
Abstract
The treat-to-target (T2T) approach has revolutionized the way we treat patients with rheumatic and musculoskeletal diseases. Recent attention has focused on imaging techniques, in particular musculoskeletal ultrasound and MRI as a focus for T2T strategies. Recently, a number of randomized clinical trials have been performed that compared tight clinical control vs control augmented by imaging techniques. While the three published trials have concluded that imaging does not add to tight clinical care, implementing imaging into the T2T strategy has actual advantages, such as the detection of subclinical involvement, and information on joint involvement/pathology and may possess potential advantages as evidenced by certain secondary endpoints. This review examines the findings of these studies and discusses the advantages and disadvantages of incorporating imaging into the T2T strategy.
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Affiliation(s)
- Peter Mandl
- Division of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Daniel Aletaha
- Division of Rheumatology, Medical University of Vienna, Vienna, Austria
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9
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Kawahara R, Nakabo S, Shimizu M, Yamamoto H, Sasai T, Nishida Y, Funakoshi S, Gon Y, Taniguchi M, Nakajima T, Hiwa R, Hashimoto M, Tomizawa T, Azukizawa M, Nishitani K, Murata K, Tanaka M, Ito H, Mimori T, Fujii Y. Feasibility of patient-oriented ultrasound joint selection: Cross-sectional observational study on rheumatoid arthritis. Mod Rheumatol 2019; 30:975-981. [DOI: 10.1080/14397595.2019.1680095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Rie Kawahara
- Department of Human Health Sciences, Clinical Ultrasound Laboratory, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shuichiro Nakabo
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Madoka Shimizu
- Department of Human Health Sciences, Clinical Ultrasound Laboratory, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroko Yamamoto
- Department of Human Health Sciences, Clinical Ultrasound Laboratory, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tsuneo Sasai
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yuri Nishida
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Sohei Funakoshi
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yoshie Gon
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masashi Taniguchi
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toshiki Nakajima
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ryosuke Hiwa
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Motomu Hashimoto
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takuya Tomizawa
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masayuki Azukizawa
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kohei Nishitani
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Koichi Murata
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masao Tanaka
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiromu Ito
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tsuneyo Mimori
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yasutomo Fujii
- Department of Human Health Sciences, Clinical Ultrasound Laboratory, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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10
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Oral health–related quality of life among individuals with rheumatoid arthritis. Clin Rheumatol 2019; 38:2433-2441. [DOI: 10.1007/s10067-019-04555-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 04/01/2019] [Accepted: 04/08/2019] [Indexed: 12/12/2022]
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11
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Peng M, Qiang L, Xu Y, Li C, Li T, Wang J. IL
‐35 ameliorates collagen‐induced arthritis by promoting
TNF
‐α‐induced apoptosis of synovial fibroblasts and stimulating M2 macrophages polarization. FEBS J 2019; 286:1972-1985. [PMID: 30834683 DOI: 10.1111/febs.14801] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 12/03/2018] [Accepted: 03/01/2019] [Indexed: 12/25/2022]
Affiliation(s)
- Mingzheng Peng
- Shanghai Key Laboratory of Orthopaedic Implant Department of Orthopaedic Surgery Shanghai Ninth People's Hospital Affiliated Shanghai Jiao Tong University School of Medicine China
| | - Lei Qiang
- Southwest Jiaotong University College of Medicine Chengdu China
| | - Yan Xu
- Southwest Jiaotong University College of Medicine Chengdu China
| | - Cuidi Li
- Med‐X Research Institute School of Biomedical Engineering Shanghai Jiao Tong University China
| | - Tao Li
- Shanghai Key Laboratory of Orthopaedic Implant Department of Orthopaedic Surgery Shanghai Ninth People's Hospital Affiliated Shanghai Jiao Tong University School of Medicine China
| | - Jinwu Wang
- Shanghai Key Laboratory of Orthopaedic Implant Department of Orthopaedic Surgery Shanghai Ninth People's Hospital Affiliated Shanghai Jiao Tong University School of Medicine China
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12
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Baffour FI, McKenzie GA, Bekele DI, Glazebrook KN. Sonography of active rheumatoid arthritis during pregnancy: a case report and literature review. Radiol Case Rep 2018; 13:1233-1237. [PMID: 30258513 PMCID: PMC6148827 DOI: 10.1016/j.radcr.2018.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 08/18/2018] [Accepted: 08/26/2018] [Indexed: 11/16/2022] Open
Abstract
Disease activity in rheumatoid arthritis usually subsides in pregnancy, however a subset of patients have worsened symptoms with joint pain and swelling. Monitoring and mitigating disease activity in pregnancy is important for preventing deforming structural changes which can affect the ability of the patient to care for themselves and the newborn. Ultrasound is a safe and low-cost imaging modality for detecting active changes from an inflammatory arthritis, which can help guide management. We describe a case of an acute disease flare during pregnancy, readily detected with ultrasound, and present a review of sonographic evaluation of rheumatoid arthritis in pregnancy.
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Affiliation(s)
- Francis I. Baffour
- Division of Musculoskeletal Radiology, Department of Radiology, 200 1st Street SW, Rochester, MN 55905
- Corresponding author.
| | - Gavin A. McKenzie
- Division of Musculoskeletal Radiology, Department of Radiology, 200 1st Street SW, Rochester, MN 55905
| | | | - Katrina N. Glazebrook
- Division of Musculoskeletal Radiology, Department of Radiology, 200 1st Street SW, Rochester, MN 55905
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