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Importance of baseline musculoskeletal ultrasound findings in the prognosis of rheumatoid arthritis

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Clinical Rheumatology Aims and scope Submit manuscript

A Correction to this article was published on 28 January 2022

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Abstract

Objectives

To investigate the prognostic value of baseline musculoskeletal ultrasound (MSUS) findings for rheumatoid arthritis (RA).

Method

We retrospectively analyzed 138 patients with RA. Patients’ first MSUS record was considered as the baseline expression. The subsequent MSUS changes that showed alleviation or progression were regarded as the cutoff point. Grayscale ultrasound (GSUS) synovitis, power Doppler ultrasound (PDUS) synovitis, PDUS tenosynovitis (TS), and bone erosion were scored using a semi-quantitative scale. According to the ultrasound (US) results of the cutoff point, patients were divided into the alleviation group and the progression group. Laboratory results (erythrocyte sedimentation rate [ESR], C-reactive protein [CRP], rheumatoid factor [RF], anticyclic citrullinated peptide [anti-CCP] antibody, and anti-keratin antibody [AKA]), disease activity score in 28 joints (DAS28)-ESR, and US scores were compared between the two groups to analyze the prognostic value of US findings in RA.

Results

The alleviation group had higher levels of CRP, synovitis, TS, GSUS synovitis, PDUS synovitis, PDUS TS, and US total scores at baseline than the progression group (p < 0.05). The alleviation group received more aggressive treatment in their initial approach than the progression group (p < 0.05). The frequency of US examinations in the alleviation group was more than that in the progression group at follow-up (p < 0.05). Presence of baseline synovitis (OR 0.248, p = 0.006) and a higher GSUS synovitis score (OR 0.521, p = 0.006) were negatively correlated with RA progression.

Conclusions

Presence of baseline synovitis and higher GSUS synovitis score do not always indicate worse prognosis of RA, which can be improved with aggressive treatment. Regular MSUS follow-up may have positive influences on prognosis.

Key Points

• The presence of synovitis at baseline and higher GSUS synovitis score do not necessarily imply poor prognosis of RA.

• Prompt and powerful therapy and regular ultrasound follow-up can slow down the progression of RA and improve its prognosis.

• Patients with slight and less arthritis at baseline might be ignored and get worse prognosis due to mild treatment strategies and irregular MSUS examination.

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Data availability

The dataset used and/or analyzed during the current study is available from the corresponding author on reasonable request.

Change history

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Acknowledgements

The authors would like to thank all the participants’ involvement in this study.

Funding

This study was supported by the Medical Science Research Project of Hebei Province (20190528) and the Chinese Medicine Scientific Research Program of Hebei Province (2020171).

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Authors and Affiliations

  1. Department of Rheumatology and Immunology, the Second Hospital of Hebei Medical University, No. 215, Heping West Road, Xinhua District, Shijiazhuang, 050000, Hebei Province, China

    Chao Sun, Xuan Qi, Yushu Yang, Lingyan Lei, Lixia Gao & Huifang Guo

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  1. Chao Sun
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  2. Xuan Qi
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  3. Yushu Yang
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  4. Lingyan Lei
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Contributions

CS, LL, and YY performed the US scans. XQ was responsible for the data collection. LG analyzed data. CS wrote the manuscript. HG was responsible for the study design. All authors contributed to revision of the report and approved the final version.

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Correspondence to Huifang Guo.

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Sun, C., Qi, X., Yang, Y. et al. Importance of baseline musculoskeletal ultrasound findings in the prognosis of rheumatoid arthritis. Clin Rheumatol 41, 847–857 (2022). https://doi.org/10.1007/s10067-021-06017-7

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