Abstract
Objective: to compare results of ultrasound examination (US) of the wrist joints (WJ) and small joints of hands with the clinical signs in patients with early rheumatoid arthritis (eRA) and hand osteoarthriti (OAH).Patients and methods. The study included 42 patients with eRA (group 1) and 38 patients with OAH (group 2). The average age of patients with eRA was 48.60±14.86 years, the duration of clinical manifestations was 7.45±1.77 months, of patients with OAH – 54.97±12.45 years and 8.26±1.83 months, respectively. The ratio of men and women in both groups was approximately the same, the majority were women. All patients with eRA had clinical and instrumentally confirmed signs of OA: I, II, and III radiological stages of OA according to Kellgren–Lawrence were detected in 10 (23.80%), 23 (54.76%) and 9 (21.43%) patients respectively. In erosive OA II and III X-ray stage was diagnosed in 16 (42.10%) and 22 (57.90%) patients, respectively. All patients underwent ultrasound of the joints, as well as a general clinical examination, which included an assessment of the number of painful joints, the number of swollen joints, and a general assessment of pain intensity using a visual analogue scale (100 mm). RA activity was determined using the DAS28 index. We also studied laboratory parameters – the levels of CRP, rheumatoid factor and antibodies to cyclic citrullinated peptide in blood serum.Results and discussion. Comparison of the two groups of patients showed that ultrasound in B-mode and power Doppler mode with eRA and OAH showed more pronounced inflammatory and destructive changes in the wrist joints and small joints of the hands, with the exception of the distal interphalangeal joints (DIPJ). In addition, only in patients of the 1st group there was a close correlation between the enhancement of the Doppler signal and levels of inflammatory markers. Conclusion. eRA compared with OAH is characterized by more pronounced ultrasound signs of inflammatory and destructive changes in the wrist joins and small joints of the hands, with the exception of DIPJ.
Highlights
Цель исследования – сопоставление результатов ультразвукового исследования (УЗИ) лучезапястных суставов (ЛЗС) и мелких суставов кистей с клинической картиной у больных ранним ревматоидным артритом и остеоартритом кистей (ОАК)
All patients underwent ultrasound of the joints, as well as a general clinical examination, which included an assessment of the number of painful joints, the number of swollen joints, and a general assessment of pain intensity using a visual analogue scale (100 mm)
Comparison of the two groups of patients showed that ultrasound in B-mode and power Doppler mode with early rheumatoid arthritis (eRA) and OAH showed more pronounced inflammatory and destructive changes in the wrist joints and small joints of the hands, with the exception of the Современная ревматология. 2021;15(2)
Summary
Фициент Коэна (κ), значение которого 0,81 – от-. Соответствие клинических симптомов данным УЗИ в В-режиме при обследовании ЛЗС и мелких суставов кистей у пациентов 1-й и 2-й групп, n (%) Table 3. Correspondence of clinical symptoms to B-mode ultrasound evidence of wrist joints and small joints of hands in patients of group 1and group 2, n (%). Число суставов бораторного обследования пациентов обеих групп представлены в табл. 1. Сравнительный анализ показал, что у пациентов 1-й группы показатели ЧПС и ЧБС (р=0,02), а также СОЭ. 37/3,25 100/8,77 и СРБ (р
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