LAUSR

Background Ultrasound becomes increasingly important in the diagnosis and management of rheumatoid arthritis (RA). Objectives Our purposes are to evaluate Naredo (NS) and Backhaus (BS) ultrasound scores of synovitis, performed in daily practice in RA and to study their correlations with clinical assessment and SHARP radiological score modified by Vander Heijde (SS). Methods This is a cross-sectional study, conducted at the Rheumatology Department of Monastir Teaching Hospital, Tunisia, in 69 consecutive patients with RA. For each patient, clinical and biological evaluation (DAS 28 score), radiological assessment (SS) and ultrasound evaluation (by TOSHIBA machine) to determine NS and BS, were performed. Results The mean age of our patients was 52.01±10.1 years.27–78 The women accounted for 89% of patients. The average of disease duration was 121±86 months [1- 333]. The mean tender joint count (TJC) was 5.9±5.6 [0–27]. The most frequently hands tender joints were the 5th MCP right, 3rd MCP right and the 1st MCP left and right. The mean swollen joint count (SJC) was 3 [0–22]. The most frequently swollen joints at both hands were the wrists and the 2nd MCP. The overall mean SS score was 105±59 [17–272], the overall mean score for joint erosion was 52±38 [0–166] and narrowing score was 53±26.3–136 The mean NS was 17±15 [0–64] and BS was 21±10.2–44 The mean duration of ultrasound assessment for calculating NS and BS was 21±7 min and 17±5 min, respectively. NS was significantly associated with SJC (p<0.000) and DAS 28 (p<0.01) but was not significantly associated with SS nor with its components. The BS was significantly associated with TJC (p<0.000), SJC (p<0.04) and DAS 28 (p<0.02). It was not significantly associated with SS. The number of erosions found by the BS was significantly associated with the erosion score of both hands and overall erosion score found by the SS (p<0.001). Ultrasound shows superiority in detecting erosions than standard radiographs: the number of erosions found by the BS was superior in 91% of cases to the number of erosions found by SS in the same joints. Conclusions NS and BS are significantly associated with RA disease activity. Ultrasound detects better osteoarticular erosions than radiological assessment. BS, which needs on average 17 min, can be used in daily practice. Reference 1 Contant, Elise, Paul Ornetti. “Ultrasound Scores: Interest in rheumatologic practice(example of rheumatoid arthritis and spondyloarthritis)”. Journal of Rheumatism Monographs 2005 September;82(4):217-24. Disclosure of Interest None declared