ORIGINAL ARTICLE |
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Year : 2015 | Volume
: 42
| Issue : 1 | Page : 19-26 |
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Verification of an ultrasonographic scoring system in discriminating rheumatoid arthritis from osteoarthritic and normal joints in an Egyptian cohorts
Naglaa GadAllah1, Mona Elhossieny1, Nouran Abaza1, Shahdan Yousry1, Samah A El-Bakry MD 2
1 Department of Physical Medicine, Rheumatology & Rehabilitation, Division of Rheumatology, Ain Shams University, Cairo, Egypt 2 Department of Internal Medicine, Division of Rheumatology, Ain Shams University, Cairo, Egypt
Correspondence Address:
Samah A El-Bakry 6 Makka Street, El Sefarat District, Nasr City, Cairo Egypt
Source of Support: None, Conflict of Interest: None | Check |
DOI: 10.4103/1110-161X.155631
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Background
The use of musculoskeletal ultrasound in rheumatoid arthritis (RA) has been growing over the last decades mainly to monitor response to treatment and for early detection of erosions. Suggestions to include this technique in the diagnosis of RA have been made, but not yet been implemented (because of the lack of specific sonographic criteria for RA).
Objectives
To verify the performance of a proposed combined structural and synovial scoring system in differentiating RA from osteoarthritis (OA) and healthy sonographic findings in the small joints of the hand.
Patients and methods
Twenty RA patients, 20 patients with hand OA, and 10 healthy controls were subjected to musculoskeletal ultrasound of the metacarpophalyngeal and proximal interphalyngeal joints. The novel proposed scoring system was applied characterizing each joint as either RA supported or RA unsupported. Grading of synovitis as mild, moderate, or severe was also performed. In the RA group, disease activity was assessed by Disease Activity Score 28 (DAS28) and anticyclic citrullinated peptide serum levels were measured.
Results
When one or more RA-supported joints were detected using this scoring system, it had a sensitivity of 100.0% and a specificity of 83.0%, with a diagnostic accuracy of 90.0%, for the diagnosis of RA. If two or more joints were detected, it had a sensitivity of 95.0% and a specificity of 96.7%, with a diagnostic accuracy of 96.0% for the diagnosis of RA.
Conclusion
The novel suggested combined structural and synovial scoring system showed high performance in differentiating RA from OA and controls. |
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