Department of Rheumatology and Clinical Immunology, Peking University First Hospital, No. 8, Xishiku Street, Beijing, 100034, China.
Clin Rheumatol. 2022 Nov;41(11):3319-3324. doi: 10.1007/s10067-022-06277-x. Epub 2022 Jul 18.
To explore the correlation between the ultrasound-detected synovitis in each individual joint at metacarpophalangeal (MCP), proximal interphalangeal (PIP), and metatarsophalangeal (MTP) regions and the clinical disease activity in patients with rheumatoid arthritis (RA).
Clinical disease activity was assessed by disease activity score (DAS) based on 28-joint count and erythrocyte sedimentation rate (DAS28-ESR), C-reactive protein (DAS28-CRP), Simplified Disease Activity Index (SDAI), and Clinical Disease Activity Index (CDAI). Gray scale (GS) and power Doppler (PD) synovitis was assessed by ultrasound semi-quantitatively. The correlation between clinical disease activity indices and synovitis score in each joint was assessed using Spearman's rank correlation test.
211 RA patients were included in this study. The whole GS scores of all MCP joints showed the highest correlation with each Clinical Disease Activity Index (r = 0.403-0.452, p < 0.01). Likewise, the whole PD scores of all MCP joints also showed the highest correlation with clinical disease activity (r = 0.332-0.396, p < 0.01). At individual joint level, the highest correlation of GS score with DAS28-ESR (r = 0.411, p < 0.01), DAS28-CRP (r = 0.459, p < 0.01), and SDAI (r = 0.444, p < 0.01) was observed in MCP3 joint while with CDAI (r = 0.421, p < 0.01) in MCP2 joint. The highest correlation of PD score with DAS28-ESR (r = 0.353, p < 0.01), DAS28-CRP (r = 0.399, p < 0.01), CDAI (r = 0.368, p < 0.01), and SDAI (r = 0.377, p < 0.01) was observed in MCP5 joint.
The ultrasound-detected synovitis at MCP joints, especially MCP2, MCP3, and MCP5 joints, was best correlated with clinical disease activity in most RA cases, in contrast to PIP and MTP joints. Key Points • The correlation of ultrasound-detected synovitis in each individual joint with the clinical disease activity in RA patients is diverse among joint regions. MCP joints showed the best, in contrast to PIP and MTP joints.
探讨掌指（MCP）、近侧指间（PIP）和跖趾（MTP）关节超声检测到的滑膜炎与类风湿关节炎（RA）患者临床疾病活动之间的相关性。
采用基于 28 关节计数和红细胞沉降率（DAS28-ESR）、C 反应蛋白（DAS28-CRP）、简化疾病活动指数（SDAI）和临床疾病活动指数（CDAI）的疾病活动评分（DAS）评估临床疾病活动。通过超声半定量评估灰度（GS）和功率多普勒（PD）滑膜炎。使用 Spearman 秩相关检验评估各关节临床疾病活动指数与滑膜炎评分之间的相关性。
本研究共纳入 211 例 RA 患者。所有 MCP 关节的整体 GS 评分与各临床疾病活动指数（r=0.403-0.452，p<0.01）相关性最高。同样，所有 MCP 关节的整体 PD 评分与临床疾病活动相关性最高（r=0.332-0.396，p<0.01）。在单个关节水平，MCP3 关节的 GS 评分与 DAS28-ESR（r=0.411，p<0.01）、DAS28-CRP（r=0.459，p<0.01）和 SDAI（r=0.444，p<0.01）相关性最高，而 MCP2 关节与 CDAI（r=0.421，p<0.01）相关性最高。MCP5 关节的 PD 评分与 DAS28-ESR（r=0.353，p<0.01）、DAS28-CRP（r=0.399，p<0.01）、CDAI（r=0.368，p<0.01）和 SDAI（r=0.377，p<0.01）相关性最高。
与 PIP 和 MTP 关节相比，大多数 RA 患者 MCP 关节（尤其是 MCP2、MCP3 和 MCP5 关节）的超声检测滑膜炎与临床疾病活动相关性最好。
