Correlation between high-frequency ultrasonography of patients with early rheumatoid arthritis and anti-CCP antibody.

OBJECTIVES

To study the correlation between high-frequency ultrasonography of patients with early rheumatoid arthritis (RA) and anti-cyclic citrullinated peptide (CCP) antibody.

METHODS

Two wrists, 1st to 5th metacarpal phalangeal (MCP) and 1st to 5th proximal interphalangeal (PIP) joints of 53 early RA patients treated from October 2015 to October 2017 and 30 healthy subjects were examined by high-frequency ultrasonography. The thicknesses of synovial membrane, sheaths of 1st to 5th extensor tendons, flexor tendons and ulnar wrist extensor tendons were measured. Related pathological changes were observed.

RESULTS

RA and control groups had significantly different thicknesses of synovium, extensor and flexor tendon sheaths (P <.001). In RA group, 14.15% of joints had cavity fluid, 5.23% had cartilage destruction, and 2.32% of bone cortices had tendon sheath effusion. The detection rates of tendon sheath effusion and tendon adhesion were 19.81% and 16.30% respectively. Anti-CCP antibody positive group had significantly different DAS28, Health Assessment Questionnaire score and rheumatoid factor positive rate from those of negative group (P <.05). Synovitis, cartilage destruction, bone erosion, tendon sheath effusion, and joint effusion were significantly positively correlated with these values (P <.05). Besides, 8.92% of joints had blood flow signals of thickening synovium, of which joints with signals in the active phase accounted for 4.37%. The resistance index (RI) of synovial artery was (0.58 ± 0.07). However, 0.94% of joints had synovial blood flow signals in the inactive phase, and RI of synovial artery was (0.67 ± 0.03). Anti-CCP antibody positive group was significantly more prone to bone erosion than negative group (P <.05).

CONCLUSIONS

For patients with early RA, high-frequency ultrasonography was more likely to detect articular cartilage destruction and bone erosion changes when anti-CCP antibody was positive. Combining anti-CCP antibody with ultrasonography can provide valuable evidence for the development of clinical treatment regimens.