Factors Influencing Concordance Between Clinical and Ultrasound Findings in Rheumatoid Arthritis - Université de Lorraine Accéder directement au contenu
Article Dans Une Revue Journal of Rheumatology Année : 2013

Factors Influencing Concordance Between Clinical and Ultrasound Findings in Rheumatoid Arthritis

Jeremie Sellam
  • Fonction : Auteur
  • PersonId : 918443
Philippe Gaudin
  • Fonction : Auteur
  • PersonId : 860175
Alain Saraux
  • Fonction : Auteur
  • PersonId : 929631

Résumé

Objective. Clinical joint examination (CJE) is less time-consuming than ultrasound (US) in rheumatoid arthritis (RA). Low concordance between CJE and US would indicate that the 2 tests provide different types of information. Knowledge of factors associated with CJE/US concordance would help to select patients and joints for US. Our objective was to identify factors associated with CJE/US concordance.Methods. Seventy-six patients with RA requiring tumor necrosis factor-alpha (TNF-alpha) antagonist therapy were included in a prospective, multicenter cohort. In each patient, 38 joints were evaluated. Synovitis was scored using CJE, B-mode US (B-US), and power Doppler US (PDUS). Joints whose kappa coefficient (kappa) for agreement CJE/US was <0.1 were considered discordant. Multivariate analysis was performed to identify factors independently associated with CJE/US concordance, defined as factors yielding p <0,05 and OR > 2.Results. Concordance before TNF-alpha antagonist therapy varied across joints for CJE/US (kappa = -0.08 to 0.51) and B-US/PDUS (kappa = 0.30 to 0.67). CJE/US concordance was low at the metatarsophalangeal joints and shoulders (kappa < 0.1). Before TNF-alpha antagonist therapy, a low 28-joint Disease Activity Score (DAS28) was associated with good CJE/B-US concordance, and no factors were associated with CJE/PDUS concordance. After TNF-alpha antagonist therapy, only the joint site was associated with CJE/B-US concordance; joint site and short disease duration were associated with CJE/PDUS concordance.Conclusion. Concordance between CJE and US is poor overall. US adds information to CJE, most notably at the metatarsophalangeal joints and shoulders. Usefulness is decreased for B-US when DAS28 is low and for PDUS when disease duration is short.

Dates et versions

hal-01454917 , version 1 (03-02-2017)

Identifiants

Citer

Marion Le Boëdec, Sandrine Jousse-Joulin, Jean-François Ferlet, Thierry Marhadour, Gérard Chales, et al.. Factors Influencing Concordance Between Clinical and Ultrasound Findings in Rheumatoid Arthritis. Journal of Rheumatology, 2013, 40 (3), pp.244-252. ⟨10.3899/jrheum.120843⟩. ⟨hal-01454917⟩
131 Consultations
0 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More