Relationship between Clinical, Serological and Ultrasound assessment of rheumatoid arthritis activity

Abstract

ur study’s aim was to assess the relationship between systematic ultrasound (US) evaluation using 7-joint and 12-joint scores and both clinical and serological evaluations in the determination of disease activity in rheumatoid arthritis patients. Also, we assessed the difference between both scores to know which is more accurate in assessing disease activity. It was a cross sectional study that was carried out on fifty-five Egyptian RA patients diagnosed according to the 2010 American College of Rheumatology (ACR)/EULAR criteria (Aletaha et al., 2010). Patients were recruited from the rheumatology outpatient clinic at Ain Shams university hospital. All patients were subjected to detailed history (including age, sex, disease duration and medication profile) taking emphasis on symptoms of musculoskeletal system, thorough clinical and musculoskeletal examination with assessment of disease activity by Clinical Disease Activity Index (CDAI), Simple Disease Activity Index (SDAI) and Disease Activity Score in 28 joints (DAS28-ESR), laboratory investigations and systemic ultrasound assessment using 7-joint and 12-joint ultrasound scores. Most of our study patients were females (90.9%) and only 5 patients were males. Age of patients ranged from 22 to 70 years with the mean±SD being 41.82 ± 9.09. The patients’ disease duration ranged from 1 to 20 years with the mean±SD being 7.35 ± 4.71. 58.2% of our patients were on oral corticosteroids and 82% of all patients were on hydroxychloroquine. Concerning conventional synthetic Disease modifying antirheumatic drugs (csDMARDs), 76% of our patients were on leflunomide, 46% on methotrexate and 27% on more than one DMARD. None was on biological DMARD.