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VOLUME 7 , ISSUE 3 ( September-December, 2020 ) > List of Articles

Original Article

Estimation of Disease Activity in Rheumatoid Arthritis: A Correlation Study between Clinical, Inflammatory Markers and Power Doppler Ultrasonography

Tuhin S Sarkar, Kripasindhu Gantait

Keywords : CRP, ESR, Rheumatoid arthritis, USG Power Doppler

Citation Information : Sarkar TS, Gantait K. Estimation of Disease Activity in Rheumatoid Arthritis: A Correlation Study between Clinical, Inflammatory Markers and Power Doppler Ultrasonography. Bengal Physician Journal 2020; 7 (3):55-56.

DOI: 10.5005/jp-journals-10070-7038

License: CC BY-NC 4.0

Published Online: 01-12-2020

Copyright Statement:  Copyright © 2020; The Author(s).


Objective: To correlate between clinical, inflammatory markers and power Doppler (PD) ultrasonography (USG) to assess the disease activity in rheumatoid arthritis (RA) patients. Methods: Sixty consecutive patients with RA were included. Demographic and clinical data, C-reactive protein (CRP) level, and erythrocyte sedimentation rate (ESR) were recorded. All patients underwent an USG PD by an experienced ultrasonologist. USG joint effusion, synovitis, and PD signal were graded from 1 to 3 in a small joint of both hands (metacarpophalangeal, proximal interphalangeal, and wrist). Joint count and joint index for effusion, synovitis, and PD signal were recorded for a total of 22 joints. Result: Among 60 patients, 41 were female and 19 were male. The correlation coefficient between ESR with tender joint, swollen joint, USG synovitis, and USG hyperemia was 0.13, 0.13, 0.58, and 0.33, respectively. The correlation coefficient between CRP with tender joint, swollen joint, USG synovitis, and USG hyperemia was 0.46, 0.07, 0.36, and 0.27, respectively. Conclusion: USG PD is an important tool along with clinical assessment and inflammatory marker to assess the disease activity in RA patients.

  1. Harrison's principle of internal medicine. 19th ed. McGraw-Hill Education/Medical; 2017. p. 2083.
  2. Malaviya AN, Kapoor SK, Singh RR, et al. Rheumatol Int 1993;13(4);131–134. DOI: 10.1007/BF00301258.
  3. Van der Heijde DMFM, van't Hof MA, van Riel PLCM, et al. Development of a disease activity score based on judgment in clinical practice by rheumatologists. J Rheumatol 1993;20(3):579–581. PMID: 8478878
  4. Felson DT, Anderson JJ, Boers M, et al. The American College of Rheumatology preliminary core set of disease activity measures for rheumatoid arthritis clinical trials. Arthritis Rheum 1993;36(6):729–740. DOI: 10.1002/art.1780360601.
  5. Terslev L, Torp-Pedersen S, Qvistgaard E, et al. Estimation of inflammation by Doppler ultrasound: quantitative changes after intra-articular treatment in rheumatoid arthritis, Ann Rheum Dis 2003;62(11):1049–1053. DOI: 10.1136/ard.62.11.1049.
  6. Naredo E, Collado P, Cruz A, et al. Longitudinal power Doppler ultrasonographic assessment of joint inflammatory activity in early rheumatoid arthritis: predictive value in disease activity and radiologic progression. Arthritis Rheum 2007;57(1):116–124. DOI: 10.1002/art.22461.
  7. Naredo E, Bonilla G, Gamero F, et al. Assessment of inflammatory activity in rheumatoid arthritis: a comparative study of clinical evaluation with grey scale and power Doppler ultrasonography. Ann Rheum Dis 2005;64(3):375–381. DOI: 10.1136/ard.2004.023929.
  8. Filippucci E, Iagnocco A, Salaffi F, et al. Power Doppler sonography monitoring of synovial perfusion at wrist joint in rheumatoid patients treated with adalimumab. Ann Rheum Dis 2006;65(11):1433–1437. DOI: 10.1136/ard.2005.044628.
  9. Hau M, Kneitz C, Tony HP, et al. High resolution ultrasound detects a decrease in pannus vascularisation of small finger joints in patients with rheumatoid arthritis receiving treatment with soluble tumour necrosis factor alpha receptor (etanercept). Ann Rheum Dis 2002;61(1):55–58. DOI: 10.1136/ard.61.1.55.
  10. Ellegaard K, Torp-Pedersen S, Terslev L, et al. Ultrasound colour Doppler measurements in a single joint as measure of disease activity in patients with rheumatoid arthritis—assessment of concurrent validity. Rheumatology 2009;48(3):254–257. DOI: 10.1093/rheumatology/ken459.
  11. Naredo E, Gamero F, Bonilla G, et al. Ultrasonographic assessment of inflammatory activity in rheumatoid arthritis: comparison of extended versus reduced joint evaluation. Clin Exp Rheumatol 2005;23(6):881–884. PMID: 16396709
  12. Hameed B, Pilcher J, Heron C, et al. The relation between composite ultrasound measures and the DAS28 score, its components and acute phase markers in adult RA. Rheumatology 2008;47(4):476–480. DOI: 10.1093/rheumatology/kem383.
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