Abstract
Introduction: Rheumatoid arthritis (RA) is the most common chronic inflammatory rheumatism. The increasing use of bone and joint ultrasound as a tool to aid in the detection of unrefined synovitis in developed countries, has led us to study the performance of ultrasound in the diagnosis of RA in subjects consulting in rheumatology at Cotonou. Study Method: Descriptive cross-sectional study of patients with RA, selected on the basis of ACR/ EULAR 2010 criteria. A complete clinical examination with imaging including X-rays and ultrasounds of the hands and feet were performed in all patients who have given their consent. The data collected was analyzed using EPI data 3.1 and SPSS 24.0 software. The significance rate was defined with a p-value -0.116), MCP (k = -0.097) and MTP (k = -0.031). Agreement was very low at the PPI level (k = 0.03). It was low at the different sites, between ultrasound and radiographic detection of lesions (k between 0.022 - 0.22). Age, positive immunologic RA factor and biological inflammatory syndrome were associated with ultrasound erosions (p = 0.0001) and only age was associated with active synovitis (p = 0.022). Conclusion: Bone and articular ultrasound is a good complementary alternative to clinical examination and radiography diagnostic in early diagnosis of RA in our developing countries, in the absence of MRI which remains a luxury.
Highlights
Rheumatoid arthritis (RA) is the most common chronic inflammatory rheumatism
The increasing use of bone and joint ultrasound as a tool to aid in the detection of unrefined synovitis in developed countries, has led us to study the performance of ultrasound in the diagnosis of RA in subjects consulting in rheumatology at Cotonou
This was a descriptive and analytical cross-sectional study carried out from October to December 2018 in the medical imaging and rheumatology departments of the CNHU-HKM in Cotonou. This was a convenience sampling by an exhaustive census of patients followed in the rheumatology department meeting the following criteria: - To be followed for at least 6 months. - Have a diagnosis of RA selected on the basis of European League Against Rheumatism (EULAR) American College of Rheumatology (ACR) 2010 criteria. - Have performed an ultrasound of the wrists, hands and feet. - Have given informed consent
Summary
Rheumatoid arthritis (RA) is the most common chronic inflammatory rheumatism. The increasing use of bone and joint ultrasound as a tool to aid in the detection of unrefined synovitis in developed countries, has led us to study the performance of ultrasound in the diagnosis of RA in subjects consulting in rheumatology at Cotonou. Conclusion: Bone and articular ultrasound is a good complementary alternative to clinical examination and radiography diagnostic in early diagnosis of RA in our developing countries, in the absence of MRI which remains a luxury. Rheumatoid arthritis (RA) is an immune-mediated chronic inflammatory joint disease in which synovial proliferation, pannus formation and bone erosions are histologic lesions [1]. It affects around 1% of the adult population of all sexes [2]. The European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR) in 2010 established criteria for the early diagnosis of RA These criteria are essentially based on clinical and biology, eliminating often late radiographic criteria [1]. Our objective was to assess the clinical and ultrasound concordance of joint lesions in rheumatoid arthritis at the National University Hospital Center-Hubert Koutoukou Maga (CNHU-HKM) Cotonou in the Republic of Benin
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