Vol.23 No.1

Original Article

Musculoskeletal ultrasonography assists the diagnostic performance of the 2010 classification criteria for rheumatoid arthritis

Authors

Shin-ya Kawashiri1 , Takahisa Suzuki1 , Akitomo Okada1 , Satoshi Yamasaki1 , Mami Tamai2 , Hideki Nakamura1 , Tomoki Origuchi3 , Akinari Mizokami4 , Masataka Uetani5 , Kiyoshi Aoyagi6 , Katsumi Eguchi7 , Atsushi Kawakami1

  • Department of Immunology and Rheumatology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
  • Center for Health and Community Medicine, Nagasaki University, Nagasaki, Japan
  • Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
  • Department of Internal Medicine, Nagasaki Municipal Hospital, Omura, Japan
  • Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
  • Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
  • Department of Internal Medicine, Sasebo City General Hospital, Sasebo, Japan
Received:

1 February 2012

Accepted:

2 March 2012

Published online:

3 April 2012

Full Text

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Abstract

Objective We investigated whether musculoskeletal ultrasonography (MSKUS) assists the diagnostic performance of the 2010 rheumatoid arthritis (RA) classification criteria.
Methods Sixty-nine early arthritis patients were consecutively enrolled. None of the patients had been treated. In MSKUS of bilateral wrist and finger joints from 22 sites, the findings obtained by gray-scale and power Doppler (PD) assessment were graded on a semiquantitative scale from 0 to 3. Plain magnetic resonance imaging (MRI) of both wrist and finger joints was also examined. Diagnosis of RA was defined by the initiation of disease-modifying antirheumatic drugs within the first 3 months. The diagnostic performance of the patients was evaluated at entry using 2010 RA classification criteria in conjunction with MSKUS.
Results The indispensable MSKUS finding for differentiating RA was the presence of a PD grade 2 or 3 that was superior to 2010 RA classification criteria or MRI-proven bone edema. We propose that the decision tree algorithm of 2010 RA classification criteria with PD grade 2 or 3 reveals the best discriminative ability.
Conclusion MSKUS, especially with a strong PD signal, is very useful to assist the diagnostic performance of the 2010 RA classification criteria in the early recognition of RA.

Key words

Rheumatoid arthritis - 2010 RA classification criteria - Ultrasonography - Power Doppler - MRI