The role of ultrasound synovitis scores for patients who are at risk of rheumatoid arthritis

Abstract

AbstractObjectivesThe development of rheumatoid arthritis (RA) has been classified into 6 phases A–F according to the present risk factors in sequence of genes, environments, autoimmunity, arthralgia and joint swelling. To clarify the ultrasound synovitis scores in at‐risk patients (phases C–E) and RA (phase F).MethodsPatients who had been experiencing hand joint symptoms for at least 6 weeks and asymptomatic patients with positive rheumatoid factor and/or anti‐cyclic citrullinated peptide antibodies were enrolled. A 40‐joint ultrasonography with semiquantitative synovitis scoring for gray scale (GS) and power Doppler (PD) images was performed.ResultsA total of 139 patients were enrolled and classified into non‐RA, phase C, phase D, phase E and phase F. Total GS scores in phases C (17.4 ± 7.0), D (16.0 ± 5.4), E (18.5 ± 7.7) and F (21.8 ± 9.1) were higher than those in non‐RA (9.8 ± 4.0, P < 0.001). The total PD score in phase F (3.1 ± 4.6) was higher than that in phases C (0.2 ± 0.5), D (0.1 ± 0.4), and E (0.1 ± 0.3), as well as in non‐RA (0.0 ± 0.0, P < 0.01). A total GS score ≥14 differentiated patients at risk for RA from patients with non‐RA (area under curve [AUC] 0.82), while a total PD score ≥2 differentiated patients with RA from patients at risk for RA (AUC 0.71).ConclusionTotal GS score may differentiate patients at risk for RA from non‐RA patients, while total PD score may differentiate patients with RA from those who are at risk for RA.