Department of Immunology and Rheumatology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
Mod Rheumatol. 2013 Jan;23(1):36-43. doi: 10.1007/s10165-012-0628-7. Epub 2012 Apr 3.
We investigated whether musculoskeletal ultrasonography (MSKUS) assists the diagnostic performance of the 2010 rheumatoid arthritis (RA) classification criteria.
Sixty-nine early arthritis patients were consecutively enrolled. None of the patients had been treated. In MSKUS of bilateral wrist and finger joints from 22 sites, the findings obtained by gray-scale and power Doppler (PD) assessment were graded on a semiquantitative scale from 0 to 3. Plain magnetic resonance imaging (MRI) of both wrist and finger joints was also examined. Diagnosis of RA was defined by the initiation of disease-modifying antirheumatic drugs within the first 3 months. The diagnostic performance of the patients was evaluated at entry using 2010 RA classification criteria in conjunction with MSKUS.
The indispensable MSKUS finding for differentiating RA was the presence of a PD grade 2 or 3 that was superior to 2010 RA classification criteria or MRI-proven bone edema. We propose that the decision tree algorithm of 2010 RA classification criteria with PD grade 2 or 3 reveals the best discriminative ability.
MSKUS, especially with a strong PD signal, is very useful to assist the diagnostic performance of the 2010 RA classification criteria in the early recognition of RA.
我们研究了肌肉骨骼超声（MSKUS）是否有助于 2010 年类风湿关节炎（RA）分类标准的诊断性能。
连续纳入 69 例早期关节炎患者。所有患者均未接受治疗。在双侧腕关节和手指关节 22 个部位的 MSKUS 中，灰阶和功率多普勒（PD）评估的结果在半定量量表上从 0 到 3 进行分级。还对双侧腕关节和手指关节的普通磁共振成像（MRI）进行了检查。RA 的诊断定义为在最初 3 个月内开始使用疾病修饰抗风湿药物。使用 2010 年 RA 分类标准结合 MSKUS 在入组时评估患者的诊断性能。
区分 RA 的不可或缺的 MSKUS 发现是存在 PD 分级 2 或 3，优于 2010 年 RA 分类标准或 MRI 证实的骨水肿。我们提出，2010 年 RA 分类标准的 PD 分级 2 或 3 的决策树算法显示出最佳的鉴别能力。
MSKUS，尤其是具有强烈 PD 信号的 MSKUS，对于早期识别 RA 中辅助 2010 年 RA 分类标准的诊断性能非常有用。
