A diagnostic algorithm for persistence of very early inflammatory arthritis: the utility of power Doppler ultrasound when added to conventional assessment tools.

Abstract:

OBJECTIVES:The aim of this study was to assess the value of power Doppler ultrasound (PDUS) in combination with routine management in a cohort of patients with very early inflammatory arthritis (IA). METHODS:50 patients with < or =12 weeks of inflammatory symptoms with or without signs had clinical, laboratory and imaging assessments. Diagnosis was recorded at 12 months. Assuming a 15% pre-test probability of IA, post-test probabilities for various assessments were calculated and used to develop a diagnostic algorithm. RESULTS:All patients positive for rheumatoid factor (RF) and/or cyclic citrullinated peptide (CCP) developed persistent IA, so the added value of PDUS was assessed in the seronegative (RF and CCP negative) group. The probability of IA in a seronegative patient was 6%. The addition of clinical and radiographic features raised the probability of IA to 30% and, with certain ultrasound features, this rose to 94%. CONCLUSIONS:In seronegative patients with early IA, combining PDUS with routine assessment can have a major impact on the certainty of diagnosis.

journal_name

Ann Rheum Dis

authors

Freeston JE,Wakefield RJ,Conaghan PG,Hensor EM,Stewart SP,Emery P

doi

10.1136/ard.2008.106658

subject

Has Abstract

pub_date

2010-02-01 00:00:00

pages

417-9

issue

2

eissn

0003-4967

issn

1468-2060

pii

ard.2008.106658

journal_volume

69

pub_type

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