Ultrasound-detected tenosynovitis independently associates with patient-reported flare in patients with rheumatoid arthritis in clinical remission: results from the observational study STARTER of the Italian Society for Rheumatology

被引：48

作者：

Bellis, Emanuela ^{[1
]}

Scire, Carlo Alberto ^{[2
]}

Carrara, Greta ^{[2
]}

Adinolfi, Antonella ^{[3
]}

Batticciotto, Alberto ^{[4
]}

Bortoluzzi, Alessandra ^{[5
]}

Cagnotto, Giovanni ^{[6
]}

Caprioli, Marta ^{[7
]}

Canzoni, Marco ^{[8
]}

Cavatorta, Francesco Paolo ^{[9
]}

De Lucia, Orazio ^{[10
]}

Di Sabatino, Valentina ^{[3
]}

Draghessi, Antonella ^{[11
]}

Filippou, Georgios ^{[3
]}

Farina, Ilaria ^{[5
]}

Focherini, Maria Cristina ^{[12
]}

Gabba, Alessandra ^{[13
]}

Gutierrez, Marwin ^{[11
]}

Idolazzi, Luca ^{[14
]}

Luccioli, Filippo ^{[15
]}

Macchioni, Pierluigi ^{[16
]}

Massarotti, Marco Sergio ^{[17
]}

Mastaglio, Claudio ^{[18
]}

Menza, Luana ^{[18
]}

Muratore, Maurizio ^{[19
]}

Parisi, Simone ^{[20
]}

Picerno, Valentina ^{[3
]}

Piga, Matteo ^{[13
]}

Ramonda, Roberta ^{[21
]}

Raffeiner, Bernd ^{[22
]}

Rossi, Daniela ^{[23
]}

Rossi, Silvia ^{[6
]}

Rossini, Paola ^{[24
]}

Sakellariou, Garifallia ^{[6
]}

Scioscia, Crescenzio ^{[25
]}

Venditti, Carlo ^{[26
]}

Volpe, Alessandro ^{[9
]}

Matucci-Cerinic, Marco ^{[27
]}

Iagnocco, Annamaria ^{[28
]}

机构：

[1] Mauriziano Hosp, Rheumatol Unit, Turin, Italy

[2] Italian Soc Rheumatol, Epidemiol Unit, Milan, Italy

[3] Univ Siena, Rheumatol Sect, Dept Med Surg & Neurosci, Via Laterina 8, I-53100 Siena, Italy

[4] Luigi Sacco Univ Hosp, Dept Rheumatol, Milan, Italy

[5] South Anna Cona Univ Hosp, Dept Rheumatol, Ferrara, Italy

[6] Univ Pavia, IRCCS Policlinico San Matteo, Div Rheumatol, I-27100 Pavia, Italy

[7] Ist Clin Pavia & Vigevano, Dept Med, Pavia, Italy

[8] AO St Andrea, Rheumatol Unit, Rome, Italy

[9] AOUP Santa Chiara, Rheumatol Unit, Trento, Italy

[10] Gaetano Pini Orthopaed Inst, Div & Chair Rheumatol, Milan, Italy

[11] Univ Policlin Marche, Clin Reumatol, Dept Rheumatol, Ancona, Italy

[12] Infermi Hosp, Rheumatol Unit, Rimini, Italy

[13] AOU Univ Clin, Rheumatol Unit, Cagliari, Italy

[14] Osped Civile, Rheumatol Unit, Verona, Italy

[15] AOS Maria Misericordia Perugia, Rheumatol Unit, Perugia, Italy

[16] Arcispedale Santa Maria Nuova IRCCS, Rheumatol Unit, Reggio Emilia, Italy

[17] Humanitas Res Hosp, Rheumatol & Clin Immunol, Rozzano, Italy

[18] Moriggia Pelascini Hosp, Rheumatol Unit, Gravedona, Italy

[19] A Galateo Hosp, Rheumatol Unit, San Cesario Di Lecce, Italy

[20] AOU Citta Salute Sci Torino, SC Reumatol, Turin, Italy

[21] Univ Padua, DIMED, Dept Med, Rheumatol Unit, Padua, Italy

[22] Bolzano Hosp, Rheumatol Unit, Bolzano, Italy

[23] G Bosco Hosp, SS Immunoreumatol, Turin, Italy

[24] PO Destra Secchia, Rheumatol Unit, Pieve Di Cadore, Italy

[25] Policlin Univ Bari, DIM Sezione Reumatol, Bari, Italy

[26] AO Rummo Benevento, Rheumatol Unit, Benevento, Italy

[27] Univ Florence, Rheumatol Unit, Florence, Italy

[28] Univ Roma La Sapienza, Dipartiment Medi Interna & Specialita Med, Rheumatol Unit, Rome, Italy

来源：

RHEUMATOLOGY | 2016年 / 55卷 / 10期

关键词：

rheumatoid arthritis; remission; tenosynovitis; ultrasound; flare; HEALTH-ASSESSMENT QUESTIONNAIRE; POWER DOPPLER ULTRASONOGRAPHY; DISEASE-ACTIVITY; MUSCULOSKELETAL ULTRASOUND; STRUCTURAL PROGRESSION; FUNCTIONAL DISABILITY; SYNOVITIS; RELAPSE; INSTRUMENT; INDEX;

D O I：

10.1093/rheumatology/kew258

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Objectives. This study aimed to estimate the prevalence of US-detected tenosynovitis in RA patients in clinical remission and to explore its clinical correlates. Methods. A total of 427 RA patients in clinical remission were consecutively enrolled from 25 Italian rheumatology centres. Tenosynovitis and synovitis were scored by US grey scale (GS) and power Doppler (PD) semi-quantitative scoring systems at wrist and hand joints. Complete clinical assessment was performed by rheumatologists blinded to the US results. A flare questionnaire was used to assess unstable remission (primary outcome), HAQ for functional disability and radiographic erosions for damage (secondary outcomes). Cross-sectional relationships between the presence of each US finding and outcome variables are presented as odds ratios (ORs) and 95% CIs, both crude and adjusted for pre-specified confounders. Results. The prevalence of tenosynovitis in clinical remission was 52.5% (95% CI 0.48, 0.57) for GS and 22.7% (95% CI 0.19, 0.27) for PD, while the prevalence of synovitis was 71.6% (95% CI 0.67, 0.76) for GS and 42% (95% CI 0.37, 0.47) for PD. Among clinical correlates, PD tenosynovitis associated with lower remission duration and morning stiffness while PD synovitis did not. Only PD tenosynovitis showed a significant association with the flare questionnaire [OR 1.95 (95% CI 1.17, 3.26)]. No cross-sectional associations were found with the HAQ. The presence of radiographic erosions associated with GS and PD synovitis but not with tenosynovitis. Conclusions. US-detected tenosynovitis is a frequent finding in RA patients in clinical remission and associates with unstable remission.

引用

页码：1826 / 1836

页数：11

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