Power Doppler ultrasound effective in predicting rheumatoid arthritis

A recent research finding published in BMC Arthritis Research and Therapy has reported that power Doppler tenosynovitis noted at baseline ultrasound evaluation is an independent predictor of rheumatoid arthritis and inflammatory arthritis in patients with clinically suspected arthralgia (CSA).

Although EULAR guidelines recommend the use of imaging modalities for diagnosing RA, there is no consensus regarding the optimal methodology to be used.  Moreover, there is a need for high-level standardization. The recent 1-year retrospective study involved 110 CSA patients, representing an ultrasound unit cohort. The multivariate analysis demonstrated that the ultrasound was able to detect features of subclinical inflammation in patients with CSA, particularly those with elevated ESR (OR 1.054; 95% CI 1.016–1.094) and ACPA (OR 1.0003; 95% CI 1.002–1.006) values.  In addition, PD tenosynovitis at baseline US assessment has been concluded as an independent predictor of both rheumatoid and inflammatory arthritis in CSA patients.

The present study findings provide novel clinical evidence on the predictive potential of US subclinical inflammation in CSA patients. It may revolutionize the currently used diagnostic modalities, as the use of conventional radiography or clinical examination may not be accurate enough or sensitive to identify the structural damage and disease activity in early disease. However, further validation of current study findings in larger ultrasound-based trials is warranted.

Reference: Molina Collada, J., López Gloria, K., Castrejón, I. et al. Ultrasound in clinically suspect arthralgia: the role of power Doppler to predict rheumatoid arthritis development. Arthritis Res Ther 23, 299 (2021). https://doi.org/10.1186/s13075-021-02685-7.