Value of ultrasonographic scores in the clinical evaluation of rheumatoid arthritis

Abstract

Objective To explore the value of ultrasonographic US7 scores in clinical evaluation of rheumatoid arthritis (RA) patients, by comparing US7 scores in RA patients with different disease activities. Methods US7 scores of 133 patients in different active stages of RA were measured and evaluated by using color Doppler ultrasonography. Then, its relationship with erythrocyte sedimentation rate (ESR), anti-CCP antibody, HAQ, DAS28 and other indicators was analyzed statistically. Results (1)Significant differences could be seen in the US7 scores of the patients with severe active RA, as compared with those of the patients with stable, mild and moderate active RA(7.0 VS 0, 7.0 VS 1.0, 7.0 VS 2.0, 7.0 VS 3.0)(P<0.05). Ultrasonographic US7 scores were positively correlated with DAS28 and HAQ.(2)US7 revealed that synovitis gray scale (GS) scores accounted for the highest (63.1%), while synovitis blood flow signal (PD) scores, tenosynovitis GS scores, tenosynovitis PD scores and bone destruction scores accounted for(18.3%), (7.2%), (4.3%) and (6.9%) respectively. The most easily affected site in synovitis was dorsal wrist synovium (82.7%), followed by volar MCP II synovium (53.3%). The most easily affected site in tenosynovitis was the dorsal wrist joint (15.8%), followed by the dorsal MCPII (15.7%). In bone destruction, the most easily affected site was ulnar MTPV (33.8%), with radialis MCPII (24.1%) being the second. Conclusions Ultrasonographic US7 scores could effectively reflect the disease activity in RA patients, and it was of good value to those with severe active RA. In US7 scores, the rate of synovitis was significantly higher than those of tenosynovitis and bone destruction, and the most easily affected site was dorsal wrist joint and palmar MCPII. Clinically, more attention should be paid to the changes in these two joints. Key words: Arthritis; Rheumatoid; Ultrasonography; Ultrasound score