Musculoskeletal ultrasonography delineates ankle symptoms in rheumatoid arthritis

作者：Toyota Yukihiro; Tamura Maasa^*; Kirino Yohei^*; Sugiyama Yumiko; Tsuchida Naomi; Kunishita Yosuke; Kishimoto Daiga; Kamiyama Reikou; Miura Yasushi; Minegishi Kaoru; Yoshimi Ryusuke; Ueda Atsuhisa; Nakajima Hideaki

来源：Modern Rheumatology, 2017, 27(3): 425-429.

DOI：10.1080/14397595.2016.1222650

• Ankle joint
• Power Doppler
• Rheumatoid arthritis
• Ultrasonography

Objectives: To clarify the use of musculoskeletal ultrasonography (US) of ankle joints in rheumatoid arthritis (RA).Methods: Consecutive RA patients with or without ankle symptoms participated in the study. The US, clinical examination (CE), and patients' visual analog scale for pain (pVAS) for ankles were assessed. Prevalence of tibiotalar joint synovitis and tenosynovitis were assessed by grayscale (GS) and power Doppler (PD) US using a semi-quantitative grading (0-3). The positive US and CE findings were defined as GS score 2 and/or PD score 1, and joint swelling and/or tenderness, respectively. Multivariate analysis with the generalized linear mixed model was performed by assigning ankle pVAS as a dependent variable.Results: Among a total of 120 ankles from 60 RA patients, positive ankle US findings were found in 21 (35.0%) patients. The concordance rate of CE and US was moderate (kappa 0.57). Of the 88 CE negative ankles, US detected positive findings in 9 (10.2%) joints. Multivariate analysis revealed that ankle US, clinical disease activity index, and foot Health Assessment Questionnaire, but not CE, was independently associated with ankle pVAS.Conclusion: US examination is useful to illustrate RA ankle involvement, especially for patients who complain ankle pain but lack CE findings.

• 出版日期2017