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Aileen Y Chang, Liliana Encinales, Jeffrey M Bethony, Gary L Simon
Supported by the Rheumatology Research Foundation and the NIH (National Center for Advancing Translational Sciences grants UL1-TR-001876 and KL2-TR-001877). We would like to thank Mogami et. al., for sharing their experience with chikungunya virus in the Brazilian context, especially highlighting the possible utility of ultrasound during the sub-acute phase to identify severe or evolving cases of arthritis. Indeed, Doppler ultrasound may be an effective approach to identify patients that might benefit from treatment with disease modifying agents such as methotrexate during the sub-acute phase...
March 7, 2018: Arthritis & Rheumatology
Mads Ammitzbøll Danielsen
Rheumatod arthritis is a chronic systemic autoimmune disease, characterized by inflammation in joints and tendon sheaths, which frequently leads to permanent and serious disability due to joint destruction, but also tendon and ligament ruptures. Clinical management of rheumatoid arthritis has traditionally been supported by biochemical and radiographic findings. However, imaging modalities like ultrasound and magnetic resonance imaging (MRI) have improved the possibility for better management of rheumatoid arthritis patients, due to higher sensitivity and specificity for detecting ongoing inflammation, this thesis is focusing on tenosynovitis as recent studies have shown that inflammation in tendon sheaths, i...
March 2018: Danish Medical Journal
Paul Emery, Gerd R Burmester, Esperanza Naredo, Yijie Zhou, Maja Hojnik, Philip G Conaghan
INTRODUCTION: The current American College of Rheumatology and European League Against Rheumatism treatment recommendations advise tapering biological disease-modifying antirheumatic drug (bDMARD) therapy in patients with rheumatoid arthritis (RA) who achieve stable clinical remission while receiving bDMARDs. However, not all patients maintain remission or low disease activity after tapering or discontinuation of bDMARDs. The aim of the Im P act of R esidual Inflammation Detected via Imaging T E chniques, D rug Levels and Patient Characteristics on the Outcome of Dose Taper I ng of Adalimumab in C linical Remission Rheumatoid Ar T hritis ( RA ) study, or PREDICTRA, is to generate data on patient and disease characteristics that may predict the clinical course of a fixed dose-tapering regimen with the bDMARD adalimumab...
February 28, 2018: BMJ Open
Paul Harkey, Richard Duszak, Soterios Gyftopoulos, Andrew B Rosenkrantz
OBJECTIVE: The purpose of this study is to identify the specialty characteristics of providers referring musculoskeletal (MSK) extremity imaging examinations to radiologists, so as to better understand the drivers of MSK imaging utilization and potentially improve the appropriateness of such imaging examinations. MATERIALS AND METHODS: Data on provider referral for MSK extremity imaging services were extracted from the 2014 Medicare Referring Provider Utilization for Procedures public use file, which aggregates data on diagnostic procedures according to referring provider identities and service codes...
February 28, 2018: AJR. American Journal of Roentgenology
Orazio De Lucia, Viviana Ravagnani, Francesca Pregnolato, Arvena Hila, Irene Pontikaki, Maurizio Gattinara, Micol Romano, Valeria Gerloni, Sara Pieropan, Antonella Murgo, Maurizio Rossini, Rolando Cimaz, Pier Luigi Meroni
OBJECTIVES: To define the correlation between joint ultrasonography and clinical examination in patients with juvenile idiopathic arthritis (JIA) and to assess whether synovitis detected by ultrasonography in clinically inactive patients predicts arthritis flares. METHODS: 88 consecutive patients with JIA-46 (52%) with persistent oligoarthritis, 15 (17%) with extended oligoarthritis, 15 (17%) with rheumatoid factor-negative polyarthritis and 12 (14%) with other forms of JIA, all clinically inactive for a minimum of 3 months-underwent ultrasound (US) assessment of 44 joints...
February 6, 2018: Annals of the Rheumatic Diseases
Frances Humby, Vasco Romão, Antonio Manzo, Andrew Filer, Serena Bugatti, Elsa Vieira-Sousa, Stephen Kelly, Mihir Wechalekar, Manzoor Ahmed, Vidalba Rocher, Rebecca Hands, Carlomaurizio Montecucco, Joao Fonseca, Costantino Pitzalis
OBJECTIVES: This study aimed to evaluate whether choice of synovial biopsy technique (arthroscopic, blind needle (BN), ultrasound (US)-portal and forceps (P&F) and US-needle biopsy (NB) translates to significant variation in synovial tissue quality and quantity with the aim of informing recommendations for choice of synovial sampling technique within clinical trials. METHODS: 159 procedures were evaluated from 5 academic rheumatology centres. H&E stained paraffin embedded synovial sections were assessed in order to determine the proportion of graded synovial fragments, total area of tissue and synovitis score per procedure...
February 6, 2018: Arthritis & Rheumatology
Rositsa Karalilova, Maria Kazakova, Anastas Batalov, Victoria Sarafian
The aim of our study was to analyze the level of the glycoprotein YKL-40 in patients with active knee osteoarthritis (OA) and to search possible correlations with local inflammation and ultrasound (US) findings. MATERIAL AND METHODS: A prospective study with fifty consecutive patients with active knee OA (diagnosed based on the American College of Rheumatology criteria for OA with radiographic confirmation) was performed. Concentrations of YKL-40 in serum and synovial fluid were measured by ELISA...
February 4, 2018: Medical Ultrasonography
Marina Carotti, Vittoria Galeazzi, Francesca Catucci, Marcello Zappia, Francesco Arrigoni, Antonio Barile, Andrea Giovagnoni
With the introduction of new biologics such as anti-TNF-alpha antibodies and other therapies in the treatment of inflammatory arthritis, capable of halting joint destruction and functional disability, there are new pressures on diagnostic and prognostic imaging. Early demonstration of pre-erosive inflammatory features and monitoring of the long-term effects of treatment are becoming increasingly important. Early detection of synovitis offers advantages in terms of allowing early instigation of therapy and may allow the identification of those patients displaying more aggressive disease who might benefit from early intervention with expensive DMARD therapy...
January 19, 2018: Acta Bio-medica: Atenei Parmensis
Mads Ammitzbøll-Danielsen, Mikkel Østergaard, Esperanza Naredo, Annamaria Iagnocco, Ingrid Möller, Maria-Antonietta D'Agostino, Frédérique Gandjbakhch, Lene Terslev
OBJECTIVE: To test the sensitivity to change of the Outcome Measures in Rheumatology Clinical Trials (OMERACT) ultrasound (US) scoring system for tenosynovitis when applied in a multicenter design. METHODS: RA patients with US-verified tenosynovitis were recruited when scheduled for treatment intensification. Tenosynovitis was assessed at baseline, and 3 and 6 months followup, using the semiquantitative OMERACT scoring system. RESULTS: Expressed in median (25th; 75th percentiles), the overall greyscale and Doppler score decreased significantly from baseline at 4 (2; 7) and 3 (2; 6), to 6 months at 2 (0; 3) and 0 (0; 1, p < 0...
December 15, 2017: Journal of Rheumatology
Esther Mossel, Suzanne Arends, Jolien F van Nimwegen, Konstantina Delli, Alja J Stel, Frans G M Kroese, Fred K L Spijkervet, Arjan Vissink, Hendrika Bootsma
OBJECTIVE: To assess whether ultrasonographic scoring of (i) both parotid and submandibular salivary glands and (ii) all individual components of the Hocevar scoring system, is needed for classifying patients as primary Sjögren's syndrome (pSS). METHODS: Ultrasound examination of the major salivary glands (sUS) was performed in 204 consecutive patients clinically suspected (n=171) or diagnosed (n=33) with pSS.Parenchymal echogenicity, homogeneity, hypoechogenic areas, hyperechogenic reflections and salivary gland posterior border were scored in left and right parotid and submandibular glands...
December 12, 2017: Annals of the Rheumatic Diseases
Stephen Kelly, Brian Davidson, Sarah Keidel, Stephan Gadola, Claire Gorman, Gary Meenagh, Piero Reynolds
BACKGROUND: Rheumatologists increasingly perform ultrasound (US) imaging to aid diagnosis and management decisions. There is a need to determine the role of US in facilitating early diagnosis of inflammatory arthritis. This study describes the impact of US use by rheumatologists on diagnosis and management of inflammatory arthritis in routine UK clinical practice. METHODS: We conducted a prospective study in four secondary care rheumatology clinics, each with one consultant who routinely used US and one who did not...
November 22, 2017: BMC Musculoskeletal Disorders
Ling Zhou, Geng Wang, Xin Liu, Jing Song, Ling Chen, Huji Xu
BACKGROUND: This study aimed to investigate the reliability and validity of serum matrix metalloproteinase-3 (MMP-3) levels and articular ultrasound (US) scores in assessing disease activity and therapeutic response in rheumatoid arthritis (RA) patients. METHODS: A total of 151 RA patients were enrolled, of whom 22 were treated with certolizumab pegol (Cimzia, CZP). The RA patients were divided into the following four subgroups according to their disease activity score in 28 joints (DAS28): stable, mild activity, moderate activity, and high activity...
November 15, 2017: Arthritis Research & Therapy
Janggun Jo, Guan Xu, Meng Cao, April Marquardt, Sheeja Francis, Girish Gandikota, Xueding Wang
By using our dual-modality system enabling simultaneous real-time ultrasound (US) and photoacoustic (PA) imaging of human peripheral joints, we explored the potential contribution of PA imaging modality to rheumatology clinic. By performing PA imaging at a single laser wavelength, the spatially distributed hemoglobin content reflecting the hyperemia in synovial tissue in metacarpophalangeal (MCP) joints of 16 patients were imaged, and compared to the results from 16 healthy controls. In addition, by performing PA imaging at two laser wavelengths, the spatially distributed hemoglobin oxygenation reflecting the hypoxia in inflammatory joints of 10 patients were imaged, and compared to the results from 10 healthy controls...
November 3, 2017: Scientific Reports
Kathleen Morrisroe, Ayano Nakayama, Jason Soon, Mark Arnold, Les Barnsley, Claire Barrett, Peter M Brooks, Stephen Hall, Patrick Hanrahan, Pravin Hissaria, Graeme Jones, Veera Srividya Katikireddi, Helen Keen, Rodger Laurent, Mandana Nikpour, Katherine Poulsen, Philip Robinson, Muriel Soden, Nigel Wood, Nicola Cook, Catherine Hill, Rachelle Buchbinder
BACKGROUND: The EVOLVE (evaluating evidence. enhancing efficiencies) initiative aims to drive safer, higher-quality patient care through identifying and reducing low-value practices. AIMS: To determine the Australian Rheumatology Association's (ARA's) 'top 5' list of low-value practices. METHODS: A working group comprising 19 rheumatologists and three trainees compiled a preliminary list. Items were retained if there was strong evidence of low-value and there was high or increasing clinical use and/or increasing cost...
October 28, 2017: Internal Medicine Journal
Marcos Cruces, Soham Al Snih, Natalí Serra-Bonett, Juan C Rivas
BACKGROUND: Rheumatoid arthritis (RA) patients with disease in clinical remission might show subclinical synovitis, which can be related to the progress of structural joint damage. OBJECTIVE: To determine and compare the degree of synovial inflammation by ultrasound (US) in patients with RA in clinical remission, treated with DMARD or combination therapy with DMARD and anti-TNF. METHODS: Hospital-based cross-sectional study of 58 patients with RA in sustained remission for at least 6 months by DAS28 <2...
October 9, 2017: Reumatología Clinica
Elizaveta Kon, Lars Engebretsen, Peter Verdonk, Stefan Nehrer, Giuseppe Filardo
BACKGROUND: Osteoarthritis (OA) is a debilitating disease resulting in substantial pain and functional limitations. A novel blood derivative has been developed to concentrate both growth factors and antagonists of inflammatory cytokines, with promising preliminary findings in terms of safety profile and clinical improvement. PURPOSE: To investigate if one intra-articular injection of autologous protein solution (APS) can reduce pain and improve function in patients affected by knee OA in a multicenter, randomized, double-blind, saline-controlled study...
January 2018: American Journal of Sports Medicine
S Stormacq, N Gauquier, O Gilliaux
We report here the case of a 3-year-old patient, who presented a left limp and a total refusal of walking, without any traumatism. Clinical examination revealed a significant pain in the left leg with a limit to the limiting mobilization. Acute phase reactants were slightly elevated. Based on the hip ultrasound, acute transient synovitis of the hip was diagnosed. Following persistent complaints, a hip plain radiography was performed, showing a discreet reshuffle at the right ischiopubic branch. The MRI of the hip revealed a discrete T2 high intensity centered on the right ischiopubic synchondrosis (IPS), corresponding to a Van Neck-Odelberg osteochondrosis...
November 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Lene Terslev, Esperanza Naredo, Philippe Aegerter, Richard J Wakefield, Marina Backhaus, Peter Balint, George A W Bruyn, Annamaria Iagnocco, Sandrine Jousse-Joulin, Wolfgang A Schmidt, Marcin Szkudlarek, Philip G Conaghan, Emilio Filippucci, Maria Antonietta D'Agostino
OBJECTIVES: To test the reliability of new ultrasound (US) definitions and quantification of synovial hypertrophy (SH) and power Doppler (PD) signal, separately and in combination, in a range of joints in patients with rheumatoid arthritis (RA) using the European League Against Rheumatisms-Outcomes Measures in Rheumatology (EULAR-OMERACT) combined score for PD and SH. METHODS: A stepwise approach was used: (1) scoring static images of metacarpophalangeal (MCP) joints in a web-based exercise and subsequently when scanning patients; (2) scoring static images of wrist, proximal interphalangeal joints, knee and metatarsophalangeal joints in a web-based exercise and subsequently when scanning patients using different acquisitions (standardised vs usual practice)...
2017: RMD Open
Maria-Antonietta D'Agostino, Lene Terslev, Philippe Aegerter, Marina Backhaus, Peter Balint, George A Bruyn, Emilio Filippucci, Walter Grassi, Annamaria Iagnocco, Sandrine Jousse-Joulin, David Kane, Esperanza Naredo, Wolfgang Schmidt, Marcin Szkudlarek, Philip G Conaghan, Richard J Wakefield
OBJECTIVES: To develop a consensus-based ultrasound (US) definition and quantification system for synovitis in rheumatoid arthritis (RA). METHODS: A multistep, iterative approach was used to: (1) evaluate the baseline agreement on defining and scoring synovitis according to the usual practice of different sonographers, using both grey-scale (GS) (synovial hypertrophy (SH) and effusion) and power Doppler (PD), by reading static images and scanning patients with RA and (2) evaluate the influence of both the definition and acquisition technique on reliability followed by a Delphi exercise to obtain consensus definitions for synovitis, elementary components and scoring system...
2017: RMD Open
Marthe Gløersen, Elisabeth Mulrooney, Alexander Mathiessen, Hilde Berner Hammer, Barbara Slatkowsky-Christensen, Karwan Faraj, Thore Isaksen, Tuhina Neogi, Tore K Kvien, Karin Magnusson, Ida Kristin Haugen
INTRODUCTION: We have limited knowledge about the underlying disease mechanisms and causes of pain in hand osteoarthritis (OA). Consequently, no disease-modifying drug exists, and more knowledge about the pathogenesis of hand OA is needed, as well as a validation of different outcome measures. Our first aim of this study is to explore the validity of various imaging modalities for the assessment of hand OA. Second, we want to gain a better understanding of the disease processes, with a special focus on pain mechanisms...
September 24, 2017: BMJ Open
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