Ultrasound Detects Subclinical Joint Inflammation in the Hands and Wrists of Patients With Systemic Lupus Erythematosus Without Musculoskeletal Symptoms
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.17/2660 |
Resumo: | OBJECTIVES: To assess the prevalence and severity of ultrasonographic abnormalities of the hand and wrist of asymptomatic patients with systemic lupus erythematosus (SLE) and compare these findings with those from patients with SLE with musculoskeletal signs or symptoms and healthy controls. METHODS: We conducted a prospective cross-sectional study that evaluated bilaterally, with grey-scale and power Doppler (PD) ultrasound (US), the dorsal hand (2nd to 5th metacarpophalangeal and 2nd to 5th proximal interphalangeal joints) and wrist (radiocarpal, ulnocarpal and intercarpal joints) of 30 asymptomatic patients with SLE, 6 symptomatic patients with SLE and 10 controls. Synovial hypertrophy (SH) and intra-articular PD signal were scored using semiquantitative grading scales (0-3). Individual scores were graded as normal (SH≤1 and PD=0) or abnormal (SH≥2 or PD≥1). Global indexes for SH and PD were also calculated. US findings were correlated with clinical and laboratory data and disease activity indexes. RESULTS: US detected SH (score ≥1) in 77% asymptomatic patients with SLE, mostly graded as minimal (score 1: 63%). 23% of the asymptomatic patients with SLE showed abnormal US PD findings (SH≥2 or PD≥1). SH was present in all symptomatic patients with SLE, mostly graded as moderate (grade 2: 67%), and with associated PD signal (83%). SH (score 1) was identified in 50% of controls, however, none presented abnormal US PD findings. SH index in the asymptomatic SLE group was higher than in the control group (2.0 (0-5) vs 0.5 (0-2), median (range), p=0.01) and lower than in the symptomatic SLE group (7.0 (4-23), median (range), p<0.001). No significant correlation was demonstrated between US PD findings and clinical or laboratory variables and disease activity indexes. CONCLUSION: A small subgroup of asymptomatic patients with SLE may present subclinical joint inflammation. Global US scores and PD signal may be important in disease evaluation and therapeutic monitoring. |
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Ultrasound Detects Subclinical Joint Inflammation in the Hands and Wrists of Patients With Systemic Lupus Erythematosus Without Musculoskeletal SymptomsSynovitisSystemic Lupus ErythematosusUltrasonographyHCC DAUTOIMHSAC DAUTOIMHSAC IMAOBJECTIVES: To assess the prevalence and severity of ultrasonographic abnormalities of the hand and wrist of asymptomatic patients with systemic lupus erythematosus (SLE) and compare these findings with those from patients with SLE with musculoskeletal signs or symptoms and healthy controls. METHODS: We conducted a prospective cross-sectional study that evaluated bilaterally, with grey-scale and power Doppler (PD) ultrasound (US), the dorsal hand (2nd to 5th metacarpophalangeal and 2nd to 5th proximal interphalangeal joints) and wrist (radiocarpal, ulnocarpal and intercarpal joints) of 30 asymptomatic patients with SLE, 6 symptomatic patients with SLE and 10 controls. Synovial hypertrophy (SH) and intra-articular PD signal were scored using semiquantitative grading scales (0-3). Individual scores were graded as normal (SH≤1 and PD=0) or abnormal (SH≥2 or PD≥1). Global indexes for SH and PD were also calculated. US findings were correlated with clinical and laboratory data and disease activity indexes. RESULTS: US detected SH (score ≥1) in 77% asymptomatic patients with SLE, mostly graded as minimal (score 1: 63%). 23% of the asymptomatic patients with SLE showed abnormal US PD findings (SH≥2 or PD≥1). SH was present in all symptomatic patients with SLE, mostly graded as moderate (grade 2: 67%), and with associated PD signal (83%). SH (score 1) was identified in 50% of controls, however, none presented abnormal US PD findings. SH index in the asymptomatic SLE group was higher than in the control group (2.0 (0-5) vs 0.5 (0-2), median (range), p=0.01) and lower than in the symptomatic SLE group (7.0 (4-23), median (range), p<0.001). No significant correlation was demonstrated between US PD findings and clinical or laboratory variables and disease activity indexes. CONCLUSION: A small subgroup of asymptomatic patients with SLE may present subclinical joint inflammation. Global US scores and PD signal may be important in disease evaluation and therapeutic monitoring.BMJ Publishing GroupRepositório do Centro Hospitalar Universitário de Lisboa Central, EPERuano, CMalheiro, ROliveira, JFPinheiro, SVieira, LSMoraes-Fontes, MF2017-03-30T14:36:48Z20172017-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.17/2660engLupus Sci Med. 2017 Jan 19;4(1):e000184.10.1136/lupus-2016-000184info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-03-10T09:38:58ZPortal AgregadorONG |
dc.title.none.fl_str_mv |
Ultrasound Detects Subclinical Joint Inflammation in the Hands and Wrists of Patients With Systemic Lupus Erythematosus Without Musculoskeletal Symptoms |
title |
Ultrasound Detects Subclinical Joint Inflammation in the Hands and Wrists of Patients With Systemic Lupus Erythematosus Without Musculoskeletal Symptoms |
spellingShingle |
Ultrasound Detects Subclinical Joint Inflammation in the Hands and Wrists of Patients With Systemic Lupus Erythematosus Without Musculoskeletal Symptoms Ruano, C Synovitis Systemic Lupus Erythematosus Ultrasonography HCC DAUTOIM HSAC DAUTOIM HSAC IMA |
title_short |
Ultrasound Detects Subclinical Joint Inflammation in the Hands and Wrists of Patients With Systemic Lupus Erythematosus Without Musculoskeletal Symptoms |
title_full |
Ultrasound Detects Subclinical Joint Inflammation in the Hands and Wrists of Patients With Systemic Lupus Erythematosus Without Musculoskeletal Symptoms |
title_fullStr |
Ultrasound Detects Subclinical Joint Inflammation in the Hands and Wrists of Patients With Systemic Lupus Erythematosus Without Musculoskeletal Symptoms |
title_full_unstemmed |
Ultrasound Detects Subclinical Joint Inflammation in the Hands and Wrists of Patients With Systemic Lupus Erythematosus Without Musculoskeletal Symptoms |
title_sort |
Ultrasound Detects Subclinical Joint Inflammation in the Hands and Wrists of Patients With Systemic Lupus Erythematosus Without Musculoskeletal Symptoms |
author |
Ruano, C |
author_facet |
Ruano, C Malheiro, R Oliveira, JF Pinheiro, S Vieira, LS Moraes-Fontes, MF |
author_role |
author |
author2 |
Malheiro, R Oliveira, JF Pinheiro, S Vieira, LS Moraes-Fontes, MF |
author2_role |
author author author author author |
dc.contributor.none.fl_str_mv |
Repositório do Centro Hospitalar Universitário de Lisboa Central, EPE |
dc.contributor.author.fl_str_mv |
Ruano, C Malheiro, R Oliveira, JF Pinheiro, S Vieira, LS Moraes-Fontes, MF |
dc.subject.por.fl_str_mv |
Synovitis Systemic Lupus Erythematosus Ultrasonography HCC DAUTOIM HSAC DAUTOIM HSAC IMA |
topic |
Synovitis Systemic Lupus Erythematosus Ultrasonography HCC DAUTOIM HSAC DAUTOIM HSAC IMA |
description |
OBJECTIVES: To assess the prevalence and severity of ultrasonographic abnormalities of the hand and wrist of asymptomatic patients with systemic lupus erythematosus (SLE) and compare these findings with those from patients with SLE with musculoskeletal signs or symptoms and healthy controls. METHODS: We conducted a prospective cross-sectional study that evaluated bilaterally, with grey-scale and power Doppler (PD) ultrasound (US), the dorsal hand (2nd to 5th metacarpophalangeal and 2nd to 5th proximal interphalangeal joints) and wrist (radiocarpal, ulnocarpal and intercarpal joints) of 30 asymptomatic patients with SLE, 6 symptomatic patients with SLE and 10 controls. Synovial hypertrophy (SH) and intra-articular PD signal were scored using semiquantitative grading scales (0-3). Individual scores were graded as normal (SH≤1 and PD=0) or abnormal (SH≥2 or PD≥1). Global indexes for SH and PD were also calculated. US findings were correlated with clinical and laboratory data and disease activity indexes. RESULTS: US detected SH (score ≥1) in 77% asymptomatic patients with SLE, mostly graded as minimal (score 1: 63%). 23% of the asymptomatic patients with SLE showed abnormal US PD findings (SH≥2 or PD≥1). SH was present in all symptomatic patients with SLE, mostly graded as moderate (grade 2: 67%), and with associated PD signal (83%). SH (score 1) was identified in 50% of controls, however, none presented abnormal US PD findings. SH index in the asymptomatic SLE group was higher than in the control group (2.0 (0-5) vs 0.5 (0-2), median (range), p=0.01) and lower than in the symptomatic SLE group (7.0 (4-23), median (range), p<0.001). No significant correlation was demonstrated between US PD findings and clinical or laboratory variables and disease activity indexes. CONCLUSION: A small subgroup of asymptomatic patients with SLE may present subclinical joint inflammation. Global US scores and PD signal may be important in disease evaluation and therapeutic monitoring. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-03-30T14:36:48Z 2017 2017-01-01T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.17/2660 |
url |
http://hdl.handle.net/10400.17/2660 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Lupus Sci Med. 2017 Jan 19;4(1):e000184. 10.1136/lupus-2016-000184 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
BMJ Publishing Group |
publisher.none.fl_str_mv |
BMJ Publishing Group |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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