Clinical Rheumatology

, Volume 36, Issue 4, pp 947–951 | Cite as

Ultrasound resistive index, power Doppler, and clinical parameters in established rheumatoid arthritis

  • Melissa Cláudia Bisi
  • Aline Defaveri do Prado
  • Deise Marcela Piovesan
  • Markus Bredemeier
  • Inês Guimarães da Silveira
  • José Alexandre de Mendonça
  • Henrique Luiz Staub
Brief Report
First Online:
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Revised:
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Abstract

Ultrasonography (US) is a useful tool for the evaluation of sinovial vascularization and proliferation in rheumatoid arthritis (RA). Accordingly, resistive index (RI) on spectral Doppler (sD) US provides a quantitative analysis of vascular inflammation, but its utility in the evaluation of RA activity has not been established. Our objective was to determine the association of RI with other US parameters of synovitis and with clinical disease activity in established RA. Patients with positive power Doppler (pD) were included in a prospective cross-sectional study. Disease activity and disability were evaluated using the Disease Activity Score in 28-joints (DAS28) and Health Assessment Questionnaire (HAQ), respectively. Gray scale (GS) synovitis, pD, and sD analyses were performed by one of two examiners in wrists and the second and third metacarpophalangeal and proximal interphalangeal joints. The 10-joint GS and 10-joint pD scores and mean RI were then calculated. Weighted kappa (WK) values were employed to assess interobserver reability, and correlations were tested using the Spearman coefficient. Ninety-five RA patients (median duration of disease of 7 years and mean DAS28 of 4.32 ± 1.66) were included. WK values in real-time US were 0.77 for synovitis, 0.87 for pD, and 0.68 for RI. There were no significant correlations of RI with 10-joint GS, 10-joint pD, DAS28, joint counts, or HAQ (P > 0.10 for all tests). Patients in remission had a mean RI similar to those with high disease activity (0.62 ± 0.10, n = 15 versus 0.63 ± 0.13, n = 34, respectively). The addition of the RI score did not seem to improve US performance in patients with established RA.

Keywords

Imaging Imaging—ultrasound Resistive index Rheumatic diseases Rheumatoid arthritis (RA) Spectral doppler 
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Notes

Compliance with ethical standards

The local ethics committee approved the study and all patients signed a written informed consent.

Disclosures

None.

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Copyright information

© International League of Associations for Rheumatology (ILAR) 2016

Authors and Affiliations

  • Melissa Cláudia Bisi
    • 1
    • 2
  • Aline Defaveri do Prado
    • 1
    • 3
  • Deise Marcela Piovesan
    • 1
  • Markus Bredemeier
    • 3
  • Inês Guimarães da Silveira
    • 1
  • José Alexandre de Mendonça
    • 4
  • Henrique Luiz Staub
    • 1
  1. 1.Rheumatology DepartmentUniversidade Pontifícia Católica do Rio Grande do Sul (PUCRS)Porto AlegreBrazil
  2. 2.Rheumatology DepartmentSão Lucas Hospital da PUCRSPorto AlegreBrazil
  3. 3.Rheumatology ServiceHospital Nossa Senhora da Conceição, Grupo Hospitalar Conceição (GHC)Porto AlegreBrazil
  4. 4.Rheumatology DepartmentUniversidade Pontifícia Católica de Campinas (PUCCAMP)CampinasBrazil

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