The value of ultrasound–defined tenosynovitis and synovitis in the prediction of persistent arthritis

Ilfita Sahbudin; Ruchir Singh; Paola De Pablo; Elizabeth Rankin; Benjamin Rhodes; Elizabeth Justice; Emma Derrett-Smith; Esther Nicole Amft; Nehal Narayan; CM McGrath; Sangeetha Baskhar; Jeanette Trickey; Mark Maybury; Karim Raza; Andrew Filer

doi:10.1093/rheumatology/keac199

The value of ultrasound–defined tenosynovitis and synovitis in the prediction of persistent arthritis

Ilfita Sahbudin, Ruchir Singh, Paola De Pablo, Elizabeth Rankin, Benjamin Rhodes, Elizabeth Justice, Emma Derrett-Smith, Esther Nicole Amft, Nehal Narayan, CM McGrath, Sangeetha Baskhar, Jeanette Trickey, Mark Maybury, Karim Raza, Andrew Filer

Inflammation and Ageing

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Abstract

Objectives: The value of ultrasound-defined tenosynovitis in predicting the persistence of inflammatory arthritis is not well described. In particular, the predictive utility of ultrasound-defined tenosynovitis of larger tendons is yet to be reported. We assessed the value of ultrasound-defined tenosynovitis alongside ultrasound-defined synovitis and clinical and serological variables in predicting persistent arthritis in an inception cohort of disease-modifying antirheumatic drug (DMARD)-naïve patients with early arthritis.

Methods: One hundred and fifty DMARD-naïve patients with clinically apparent synovitis of one or more joints and a symptom duration ⩽3 months underwent baseline clinical, laboratory and ultrasound (of 19 bilateral joints and 16 bilateral tendon compartments) assessments. Outcomes were classified as persistent or resolving arthritis after 18 months follow-up. The predictive value of ultrasound-defined tenosynovitis for persistent arthritis was compared with those of ultrasound-defined synovitis, clinical and serological variables.

Results: At 18 months, 99 patients (66%) had developed persistent arthritis and 51 patients (34%) had resolving disease. Multivariate logistic regression analysis showed that ultrasound-detected digit flexor tenosynovitis (OR:6.6,95%CI:2.0-22.1,p=0.002) provided independent predictive data for persistence over and above the presence of ultrasound-detected joint synovitis and rheumatoid factor antibodies. In the RF/ACPA-negative sub-cohort, ultrasound-defined digit flexor tenosynovitis remained a significant predictive variable (OR:4.7,95%CI:1.4-15.8,p=0.012), even after adjusting for ultrasound-defined joint synovitis.

Conclusion: Ultrasound-defined tenosynovitis provided independent predictive data for the development of persistent arthritis. The predictive role of ultrasound-defined digit flexor tenosynovitis should be further assessed; investigators should consider including this tendon site as a candidate variable when designing imaging-based predictive algorithms for persistent inflammatory arthritis development.

Original language	English
Article number	keac199
Number of pages	13
Journal	Rheumatology (Oxford, England)
Volume	2022
Early online date	12 Apr 2022
DOIs	https://doi.org/10.1093/rheumatology/keac199
Publication status	E-pub ahead of print - 12 Apr 2022

Bibliographical note

VoR not yet published as of 20/09/2022

Keywords

early arthritis
ultrasound
prediction
persistent arthritis

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10.1093/rheumatology/keac199Licence: Creative Commons: Attribution (CC BY)

Sahbudin2022_the_Value_of_Ultrasound-defined_tenosynovitisFinal published version, 2.29 MBLicence: Creative Commons: Attribution (CC BY)

Rheumatoid Arthritis Centre for Excellence (RACE 2)
Filer, A., Lord, J., Raza, K., Scheel-Toellner, D., Anderson, G., Buckley, C., Clark, A. & Falahee, M.
ARTHRITIS RESEARCH UK
1/04/19 → 30/09/25
Project: Research

Cite this

Sahbudin, I., Singh, R., De Pablo, P., Rankin, E., Rhodes, B., Justice, E., Derrett-Smith, E., Amft, E. N., Narayan, N., McGrath, CM., Baskhar, S., Trickey, J., Maybury, M., Raza, K., & Filer, A. (2022). The value of ultrasound–defined tenosynovitis and synovitis in the prediction of persistent arthritis. Rheumatology (Oxford, England), 2022, Article keac199. Advance online publication. https://doi.org/10.1093/rheumatology/keac199

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title = "The value of ultrasound–defined tenosynovitis and synovitis in the prediction of persistent arthritis",

abstract = "Objectives: The value of ultrasound-defined tenosynovitis in predicting the persistence of inflammatory arthritis is not well described. In particular, the predictive utility of ultrasound-defined tenosynovitis of larger tendons is yet to be reported. We assessed the value of ultrasound-defined tenosynovitis alongside ultrasound-defined synovitis and clinical and serological variables in predicting persistent arthritis in an inception cohort of disease-modifying antirheumatic drug (DMARD)-na{\"i}ve patients with early arthritis. Methods: One hundred and fifty DMARD-na{\"i}ve patients with clinically apparent synovitis of one or more joints and a symptom duration ⩽3 months underwent baseline clinical, laboratory and ultrasound (of 19 bilateral joints and 16 bilateral tendon compartments) assessments. Outcomes were classified as persistent or resolving arthritis after 18 months follow-up. The predictive value of ultrasound-defined tenosynovitis for persistent arthritis was compared with those of ultrasound-defined synovitis, clinical and serological variables.Results: At 18 months, 99 patients (66%) had developed persistent arthritis and 51 patients (34%) had resolving disease. Multivariate logistic regression analysis showed that ultrasound-detected digit flexor tenosynovitis (OR:6.6,95%CI:2.0-22.1,p=0.002) provided independent predictive data for persistence over and above the presence of ultrasound-detected joint synovitis and rheumatoid factor antibodies. In the RF/ACPA-negative sub-cohort, ultrasound-defined digit flexor tenosynovitis remained a significant predictive variable (OR:4.7,95%CI:1.4-15.8,p=0.012), even after adjusting for ultrasound-defined joint synovitis. Conclusion: Ultrasound-defined tenosynovitis provided independent predictive data for the development of persistent arthritis. The predictive role of ultrasound-defined digit flexor tenosynovitis should be further assessed; investigators should consider including this tendon site as a candidate variable when designing imaging-based predictive algorithms for persistent inflammatory arthritis development. ",

keywords = "early arthritis, ultrasound, prediction, persistent arthritis",

author = "Ilfita Sahbudin and Ruchir Singh and {De Pablo}, Paola and Elizabeth Rankin and Benjamin Rhodes and Elizabeth Justice and Emma Derrett-Smith and Amft, {Esther Nicole} and Nehal Narayan and CM McGrath and Sangeetha Baskhar and Jeanette Trickey and Mark Maybury and Karim Raza and Andrew Filer",

note = "VoR not yet published as of 20/09/2022",

year = "2022",

month = apr,

day = "12",

doi = "10.1093/rheumatology/keac199",

language = "English",

volume = "2022",

journal = "Rheumatology (Oxford, England)",

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Sahbudin, I , Singh, R , De Pablo, P, Rankin, E, Rhodes, B, Justice, E, Derrett-Smith, E, Amft, EN, Narayan, N, McGrath, CM, Baskhar, S, Trickey, J, Maybury, M, Raza, K & Filer, A 2022, 'The value of ultrasound–defined tenosynovitis and synovitis in the prediction of persistent arthritis', Rheumatology (Oxford, England), vol. 2022, keac199. https://doi.org/10.1093/rheumatology/keac199

TY - JOUR

T1 - The value of ultrasound–defined tenosynovitis and synovitis in the prediction of persistent arthritis

AU - Sahbudin, Ilfita

AU - Singh, Ruchir

AU - De Pablo, Paola

AU - Rankin, Elizabeth

AU - Rhodes, Benjamin

AU - Justice, Elizabeth

AU - Derrett-Smith, Emma

AU - Amft, Esther Nicole

AU - Narayan, Nehal

AU - McGrath, CM

AU - Baskhar, Sangeetha

AU - Trickey, Jeanette

AU - Maybury, Mark

AU - Raza, Karim

AU - Filer, Andrew

N1 - VoR not yet published as of 20/09/2022

PY - 2022/4/12

Y1 - 2022/4/12

N2 - Objectives: The value of ultrasound-defined tenosynovitis in predicting the persistence of inflammatory arthritis is not well described. In particular, the predictive utility of ultrasound-defined tenosynovitis of larger tendons is yet to be reported. We assessed the value of ultrasound-defined tenosynovitis alongside ultrasound-defined synovitis and clinical and serological variables in predicting persistent arthritis in an inception cohort of disease-modifying antirheumatic drug (DMARD)-naïve patients with early arthritis. Methods: One hundred and fifty DMARD-naïve patients with clinically apparent synovitis of one or more joints and a symptom duration ⩽3 months underwent baseline clinical, laboratory and ultrasound (of 19 bilateral joints and 16 bilateral tendon compartments) assessments. Outcomes were classified as persistent or resolving arthritis after 18 months follow-up. The predictive value of ultrasound-defined tenosynovitis for persistent arthritis was compared with those of ultrasound-defined synovitis, clinical and serological variables.Results: At 18 months, 99 patients (66%) had developed persistent arthritis and 51 patients (34%) had resolving disease. Multivariate logistic regression analysis showed that ultrasound-detected digit flexor tenosynovitis (OR:6.6,95%CI:2.0-22.1,p=0.002) provided independent predictive data for persistence over and above the presence of ultrasound-detected joint synovitis and rheumatoid factor antibodies. In the RF/ACPA-negative sub-cohort, ultrasound-defined digit flexor tenosynovitis remained a significant predictive variable (OR:4.7,95%CI:1.4-15.8,p=0.012), even after adjusting for ultrasound-defined joint synovitis. Conclusion: Ultrasound-defined tenosynovitis provided independent predictive data for the development of persistent arthritis. The predictive role of ultrasound-defined digit flexor tenosynovitis should be further assessed; investigators should consider including this tendon site as a candidate variable when designing imaging-based predictive algorithms for persistent inflammatory arthritis development.

AB - Objectives: The value of ultrasound-defined tenosynovitis in predicting the persistence of inflammatory arthritis is not well described. In particular, the predictive utility of ultrasound-defined tenosynovitis of larger tendons is yet to be reported. We assessed the value of ultrasound-defined tenosynovitis alongside ultrasound-defined synovitis and clinical and serological variables in predicting persistent arthritis in an inception cohort of disease-modifying antirheumatic drug (DMARD)-naïve patients with early arthritis. Methods: One hundred and fifty DMARD-naïve patients with clinically apparent synovitis of one or more joints and a symptom duration ⩽3 months underwent baseline clinical, laboratory and ultrasound (of 19 bilateral joints and 16 bilateral tendon compartments) assessments. Outcomes were classified as persistent or resolving arthritis after 18 months follow-up. The predictive value of ultrasound-defined tenosynovitis for persistent arthritis was compared with those of ultrasound-defined synovitis, clinical and serological variables.Results: At 18 months, 99 patients (66%) had developed persistent arthritis and 51 patients (34%) had resolving disease. Multivariate logistic regression analysis showed that ultrasound-detected digit flexor tenosynovitis (OR:6.6,95%CI:2.0-22.1,p=0.002) provided independent predictive data for persistence over and above the presence of ultrasound-detected joint synovitis and rheumatoid factor antibodies. In the RF/ACPA-negative sub-cohort, ultrasound-defined digit flexor tenosynovitis remained a significant predictive variable (OR:4.7,95%CI:1.4-15.8,p=0.012), even after adjusting for ultrasound-defined joint synovitis. Conclusion: Ultrasound-defined tenosynovitis provided independent predictive data for the development of persistent arthritis. The predictive role of ultrasound-defined digit flexor tenosynovitis should be further assessed; investigators should consider including this tendon site as a candidate variable when designing imaging-based predictive algorithms for persistent inflammatory arthritis development.

KW - early arthritis

KW - ultrasound

KW - prediction

KW - persistent arthritis

U2 - 10.1093/rheumatology/keac199

DO - 10.1093/rheumatology/keac199

M3 - Article

C2 - 35412605

SN - 1462-0324

VL - 2022

JO - Rheumatology (Oxford, England)

JF - Rheumatology (Oxford, England)

M1 - keac199

ER -

The value of ultrasound–defined tenosynovitis and synovitis in the prediction of persistent arthritis

Abstract

Bibliographical note

Keywords

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Projects

Rheumatoid Arthritis Centre for Excellence (RACE 2)

Cite this