Di Matteo Andrea, Corradini Davide, Mankia Kulveer
Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, "Carlo Urbani" Hospital, Jesi, 60035 Ancona, Italy.
Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds LS74SA, UK.
Healthcare (Basel). 2021 Jun 18;9(6):752. doi: 10.3390/healthcare9060752.
The identification of biomarkers that help identify individuals at imminent risk of progression to rheumatoid arthritis (RA) is of crucial importance for disease prevention. In recent years, several studies have highlighted the value of musculoskeletal (MSK) ultrasound (US) in predicting progression to inflammatory arthritis (IA) in individuals 'at-risk' of RA. These studies have highlighted the following main aspects: first, in RA-related autoantibody-positive individuals, MSK symptoms seem to develop before 'sub-clinical' joint inflammation occurs on US. Second, the detection of 'sub-clinical' synovitis (and/or bone erosions) greatly increases the risk of IA development in these 'at-risk' individuals. US has a potential key role for better understanding the 'pre-clinical' stages in individuals 'at-risk' of RA, and for the early identification of those individuals at high risk of developing IA. Further research is needed to address questions on image analysis and standardization. In this review, we provide an overview of the most relevant studies which have investigated the value of US in the prediction of RA development in individuals 'at-risk' of RA who have MSK symptoms, but no clinical evidence of IA. We highlight recent insights, limitations, and future perspectives of US use in this important population.
识别有助于确定即将发展为类风湿性关节炎（RA）的个体的生物标志物对于疾病预防至关重要。近年来，多项研究强调了肌肉骨骼（MSK）超声（US）在预测有RA“风险”的个体发展为炎性关节炎（IA）方面的价值。这些研究突出了以下主要方面：首先，在与RA相关的自身抗体阳性个体中，MSK症状似乎在US显示“亚临床”关节炎症出现之前就已出现。其次，检测到“亚临床”滑膜炎（和/或骨侵蚀）会大大增加这些“有风险”个体发生IA的风险。US在更好地理解有RA“风险”个体的“临床前”阶段以及早期识别有发展为IA高风险的个体方面具有潜在的关键作用。需要进一步研究来解决图像分析和标准化方面的问题。在本综述中，我们概述了最相关的研究，这些研究调查了US在预测有MSK症状但无IA临床证据的RA“有风险”个体发生RA方面的价值。我们强调了US在这一重要人群中应用的最新见解、局限性和未来展望。
