Abstract

MOLLERACH, Florencia Beatriz et al. Subclinical tenosynovitis detected by ultrasound in patients with rheumatoid arthritis under sustained clinical remission. Rev. argent. reumatolg. [online]. 2018, vol.29, n.2, pp.28-33. ISSN 0327-4411.

The aims were to evaluate prevalence of ultrasound (US) tenosynovitis in Rheumatoid Arthritis (RA) patients in sustained clinical remission, its association with disease features and to assess whether the presence of tenosynovitis could add information to synovitis to define ultrasound (US) remission. Sixty consecutive RA patients in sustained (≥12 months) clinical remission (DAS28 <2.6, CDAI <2.8 and/or SDAI <3.3) were included. All patients underwent US examination by the same experienced rheumatologist. The following were bilaterally assessed: 1^st-6^th extensor tendon compartments at wrist level, 2^nd-5^th finger flexor tendons, posterior tibial, peroneal tendons, wrists, 2^nd-5^th metacarpophalangeal and 2^nd-5^th proximal interphalangeal. US remission was defined as the absence of synovitis on gray scale (GS ≥2) and the absence of power doppler (PD) signal at both joint and tendon level. Grey scale ≥2 and PD tenosynovitis were detected in 14 (23%; 95% CI: 12-34) and 13 (21.7%; 95% CI: 10-32) RA patients in clinical remission, respectively. The most frequent involved tendons were: 6^th extensor wrist compartment, 3^rd finger flexor and posterior tibials. In multivariate analysis, the only feature associated with the presence of subclinical tenosynovitis was erythrosedimentation rate (ESR)(OR: 1.11; 1.02-1.22). Twenty-nine (48.3%; 95% CI: 35-60) patients had subclinical synovitis and were not classified as in US remission. Adding the information of subclinical tenosynovitis, 6 more patients would have been classified as not in US remission, yielding a total of 35 patients (58.3%; 95% CI: 45-70) (p=0.272).

Keywords : rheumatoid arthritis; remission; tenosynovitis; ultrasound; doppler.

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