The value of ultrasound-defined tenosynovitis and synovitis in the prediction of persistent arthritis.
Sahbudin, Ilfita Singh, Ruchir de Pablo, Paola Rankin, Elizabeth Rhodes, Benjamin Justice, Elizabeth Derrett-Smith, Emma Amft, Nicole Narayan, Nehal McGrath, Catherine
Sahbudin, Ilfita
Singh, Ruchir
de Pablo, Paola
Rankin, Elizabeth
Rhodes, Benjamin
Justice, Elizabeth
Derrett-Smith, Emma
Amft, Nicole
Narayan, Nehal
McGrath, Catherine
Citations
Altmetric:
Affiliation
Institute of Inflammation and Ageing; University of Birmingham; Sandwell and West Birmingham HS Trust
Other Contributors
Publication date
2023-03
Subject
Collections
Research Projects
Organizational Units
Journal Issue
Abstract
Objectives: The value of US-defined tenosynovitis in predicting the persistence of inflammatory arthritis is not well described. In particular, the predictive utility of US-defined tenosynovitis of larger tendons is yet to be reported. We assessed the value of US-defined tenosynovitis alongside US-defined synovitis and clinical and serological variables in predicting persistent arthritis in an inception cohort of DMARD-naïve patients with early arthritis.
Methods: One hundred and fifty DMARD-naïve patients with clinically apparent synovitis of one or more joints and a symptom duration of ≤3 months underwent baseline clinical, laboratory and US (of 19 bilateral joints and 16 bilateral tendon compartments) assessments. Outcomes were classified as persistent or resolving arthritis after 18 months' follow-up. The predictive value of US-defined tenosynovitis for persistent arthritis was compared with those of US-defined synovitis, and clinical and serological variables.
Results: At 18 months, 99 patients (66%) had developed persistent arthritis and 51 patients (34%) had resolving disease. Multivariate logistic regression analysis showed that US-detected digit flexor tenosynovitis [odds ratio (OR): 6.6, 95% CI: 2.0 , 22.1, P = 0.002] provided independent predictive data for persistence over and above the presence of US-detected joint synovitis and RF antibodies. In the RF/ACPA-negative subcohort, US-defined digit flexor tenosynovitis remained a significant predictive variable (OR: 4.7, 95% CI: 1.4, 15.8, P = 0.012), even after adjusting for US-defined joint synovitis.
Conclusion: US-defined tenosynovitis provided independent predictive data for the development of persistent arthritis. The predictive role of US-defined digit flexor tenosynovitis should be further assessed; investigators should consider including this tendon site as a candidate variable when designing imaging-based predictive algorithms for persistent inflammatory arthritis development
Citation
Sahbudin I, Singh R, De Pablo P, Rankin E, Rhodes B, Justice E, Derrett-Smith E, Amft N, Narayan N, McGrath C, Baskar S, Trickey J, Maybury M, Raza K, Filer A. The value of ultrasound-defined tenosynovitis and synovitis in the prediction of persistent arthritis. Rheumatology (Oxford). 2023 Mar 1;62(3):1057-1068. doi: 10.1093/rheumatology/keac199.N
Type
Article