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Painless and painful synovitis have similar ultrasound and clinical outcomes: one-year cohort study in longstanding rheumatoid arthritis women patients


1, 2, 3, 4, 5, 6

 

  1. Rheumatology Division, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil.
  2. Rheumatology Division, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. jnatour@unifesp.br
  3. Rheumatology Division, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil.
  4. Radiology Division, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil.
  5. Radiology Division, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil.
  6. Rheumatology Division, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil.

CER13001
2021 Vol.39, N°3
PI 0621, PF 0630
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PMID: 32662403 [PubMed]

Received: 10/12/2019
Accepted : 15/06/2020
In Press: 10/07/2020
Published: 21/05/2021

Abstract

OBJECTIVES:
We aimed to compare the painless synovitis evolution with painful synovitis, based on bone erosion by ultrasonography over a year in women with longstanding rheumatoid arthritis. Ultrasound inflammatory measurements and radiographic, functional and clinical findings were also compared between groups at the end of the same follow-up.
METHODS:
A prospective cohort study was rolled out, involving 60 women with RA, divided into two groups: painless and painful, with 30 patients in each group. The wrist and MCPs joints were assessed by ultrasound and plain x-ray, initially and after 12 months (T0 and T12). There was also a clinical assessment (activity scores, functional tests, disease and treatment progression variables) at 6 and 12 months.
RESULTS:
Patients’ average age was 58.0±12.8 and average length of disease 16.4±9.8 years. Initially, the demographic characteristics were similar between groups, however, the painful group had worse clinical and functional scores. There were no statistically significant differences in the majority of US bone erosions and US inflammatory measurements, nor in radiographic progression variables between the groups. Over one year, pinch strength test and DAS 28 remained worse in the painful group (p<0.05). Clinical worsening variables and change of treatment evolved similarly between the groups, on T6 and T12.
CONCLUSIONS:
According to the study, the painless group progressed similarly to the painful one over a year, as regards bone erosion, ultrasound inflammatory measurements, radiographic findings, clinical worsening and change of treatment in female longstanding RA patients.

Rheumatology Article