Sonia Cabrera-Villalba1, Julio Ramirez1, Georgina Salvador1, Virginia Ruiz-Esquide1, M Victoria Hernández1, José Inciarte-Mundo1, José A Gómez-Puerta1, Juan D Cañete1, Raimon Sanmarti2. 1. From the Arthritis Unit, Rheumatology Service, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Hospital Mútua de Terrassa, Terrassa, Barcelona, Spain; Division of Rheumatology, Immunology and Allergy, Section of Clinical Sciences, Brigham and Women's Hospital, Boston, Massachusetts, USA.S. Cabrera-Villalba, MD; J. Ramirez, MD, Arthritis Unit, Rheumatology Service, Hospital Clinic of Barcelona, IDIBAPS; G. Salvador, MD, PhD, Hospital Mútua de Terrassa; V. Ruiz-Esquide, MD, PhD; M.V. Hernández, MD, PhD; J. Inciarte-Mundo, MD, Arthritis Unit, Rheumatology Service, Hospital Clinic of Barcelona, IDIBAPS; J.A. Gómez-Puerta, MD, PhD, Division of Rheumatology, Immunology and Allergy, Section of Clinical Sciences, Brigham and Women's Hospital; J.D. Cañete, MD, PhD; R. Sanmarti, MD, PhD, Arthritis Unit, Rheumatology Service, Hospital Clinic of Barcelona, IDIBAPS. 2. From the Arthritis Unit, Rheumatology Service, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Hospital Mútua de Terrassa, Terrassa, Barcelona, Spain; Division of Rheumatology, Immunology and Allergy, Section of Clinical Sciences, Brigham and Women's Hospital, Boston, Massachusetts, USA.S. Cabrera-Villalba, MD; J. Ramirez, MD, Arthritis Unit, Rheumatology Service, Hospital Clinic of Barcelona, IDIBAPS; G. Salvador, MD, PhD, Hospital Mútua de Terrassa; V. Ruiz-Esquide, MD, PhD; M.V. Hernández, MD, PhD; J. Inciarte-Mundo, MD, Arthritis Unit, Rheumatology Service, Hospital Clinic of Barcelona, IDIBAPS; J.A. Gómez-Puerta, MD, PhD, Division of Rheumatology, Immunology and Allergy, Section of Clinical Sciences, Brigham and Women's Hospital; J.D. Cañete, MD, PhD; R. Sanmarti, MD, PhD, Arthritis Unit, Rheumatology Service, Hospital Clinic of Barcelona, IDIBAPS. sanmarti@clinic.cat.
Abstract
OBJECTIVE: To investigate the presence of subclinical synovitis by ultrasound (US) and the clinical phenotype in patients with palindromic rheumatism (PR) according to anticitrullinated protein antibody (ACPA) status. METHODS: Fifty-four patients with PR were studied. Clinical, demographic, serological, and therapeutic characteristics were compared in ACPA-positive and ACPA-negative patients. US searching for synovial hypertrophy (SH) and power Doppler signal (PDUS) in 22 joints of the hands was performed in the intercritical period. The results were compared according to ACPA status and with a healthy control group (n = 30). In 10 patients, US was performed during the joint attack. RESULTS: Most patients were female (63%) with a mean disease duration of 11.6 ± 10.7 years. Thirty-six patients (66.7%) were ACPA-positive. ACPA-positive patients had a shorter duration of attacks, a younger age, and less knee involvement at disease onset. US examination showed SH grade ≥ 1 in 79.6% of patients with PR and 50% of controls. Significant US results (SH ≥ 2 or PDUS) were observed in 2.7% and 1.4% of joints assessed and in 33% and 25.9% of patients with PR, respectively. Only 4 patients (7.4%) had US active synovitis (SH ≥ 2 plus PDUS) in at least 1 joint. US assessment showed no significant differences between ACPA-positive and ACPA-negative patients. PDUS was observed in 7 out of 10 patients during attacks. CONCLUSION: Some differences emerged in the clinical phenotype of PR according to ACPA status. Most patients with PR do not have US subclinical synovitis in the intercritical period, even those who are ACPA-positive.
OBJECTIVE: To investigate the presence of subclinical synovitis by ultrasound (US) and the clinical phenotype in patients with palindromic rheumatism (PR) according to anticitrullinated protein antibody (ACPA) status. METHODS: Fifty-four patients with PR were studied. Clinical, demographic, serological, and therapeutic characteristics were compared in ACPA-positive and ACPA-negative patients. US searching for synovial hypertrophy (SH) and power Doppler signal (PDUS) in 22 joints of the hands was performed in the intercritical period. The results were compared according to ACPA status and with a healthy control group (n = 30). In 10 patients, US was performed during the joint attack. RESULTS: Most patients were female (63%) with a mean disease duration of 11.6 ± 10.7 years. Thirty-six patients (66.7%) were ACPA-positive. ACPA-positive patients had a shorter duration of attacks, a younger age, and less knee involvement at disease onset. US examination showed SH grade ≥ 1 in 79.6% of patients with PR and 50% of controls. Significant US results (SH ≥ 2 or PDUS) were observed in 2.7% and 1.4% of joints assessed and in 33% and 25.9% of patients with PR, respectively. Only 4 patients (7.4%) had US active synovitis (SH ≥ 2 plus PDUS) in at least 1 joint. US assessment showed no significant differences between ACPA-positive and ACPA-negative patients. PDUS was observed in 7 out of 10 patients during attacks. CONCLUSION: Some differences emerged in the clinical phenotype of PR according to ACPA status. Most patients with PR do not have US subclinical synovitis in the intercritical period, even those who are ACPA-positive.
Entities:
Keywords:
ANTICITRULLINATED PROTEIN ANTIBODIES; PALINDROMIC RHEUMATISM; SUBCLINICAL SYNOVITIS; ULTRASOUND
Authors: Sonia Cabrera-Villalba; María José Gomara; Juan D Cañete; Julio Ramírez; Georgina Salvador; Virginia Ruiz-Esquide; Maria Victoria Hernández; José Inciarte-Mundo; Isabel Haro; Raimon Sanmartí Journal: Arthritis Res Ther Date: 2017-06-15 Impact factor: 5.156
Authors: Raul Castellanos-Moreira; Sebastian C Rodriguez-Garcia; Sonia Cabrera-Villalba; María José Gomara; Georgina Salvador; Virginia Ruiz-Esquide; Julio Ramirez; Jose Inciarte-Mundo; Rosa Morla; Cristina Garcia-Moreno; Andrea Cuervo; Jose A Gómez-Puerta; Juan D Cañete; Isabel Haro; Raimon Sanmarti Journal: Ther Adv Musculoskelet Dis Date: 2020-12-10 Impact factor: 5.346
Authors: Raimon Sanmartí; Beatriz Frade-Sosa; Rosa Morlà; Raul Castellanos-Moreira; Sonia Cabrera-Villalba; Julio Ramirez; Georgina Salvador; Isabel Haro; Juan D Cañete Journal: Front Med (Lausanne) Date: 2021-03-25