Friday, 19 Jul 2019

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Ultrasound Predicts Inflammatory Arthritis in CCP+ Persons Without Synovitis

A prospective study of 136 people who were CCP+, but who had no clinical evidence of synovitis, examined what factors may predict future development of inflammatory arthritis.

After a mean of 18 mos, 42% were diagnosed with inflammatory arthritis and 49/57 met ACR/EULAR criteria for the diagnosis of rheumatoid arthritis (RA). 

Using ultrasound, 96% of the 136 patients had a gray scale (GS) signal, 30% had a power doppler signal (PD) and 21% had one or more erosions by ultrasound.  

Progression to IA was significantly higher in those with ultrasound findings in any joint (excluding MTPs for GS).  When ultrasound found a GS ≥2, PD ≥2 or erosion ≥1, a significant 2.3 - 3.7 fold increase risk of future IA was seen.

Ultrasound features of joint inflammation may be detected in anti-CCP-positive patients without CS. Ultrasound findings predict progression (and rate of progression) to IA, with the risk of progression highest in those with PD signal.

The author has no conflicts of interest to disclose related to this subject

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