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Joint Bone Spine
Volume 85, n° 6
pages 741-745 (décembre 2018)
Doi : 10.1016/j.jbspin.2018.01.013
accepted : 31 January 2018
Original Articles

Ultrasonography and detection of subclinical joints and tendons involvements in Systemic Lupus erythematosus (SLE) patients: A cross-sectional multicenter study
 

Carine Salliot a, , Amélie Denis b, Emmanuelle Dernis b, Vincent Andre b, Aleth Perdriger c, Jean-David Albert c, Saloua Mammou Mraghni d, Isabelle Griffoul-Espitalier d, Mohamed Hamidou e, Benoit Le Goff f, Sandrine Jousse Joulin g, Thierry Marhadour g, Christophe Richez h, Nicolas Poursac h, Estebaliz Lazaro i, Stéphanie Rist a, Anca Corondan a, Clara Quinten a, Virginie Martaillé a, Antoine Valéry j, Emilie Ducourau a
a Rheumatology Unit, centre hospitalier regional d’Orleans, 14, avenue de l’Hôpital, CS 86709, 45067 Orleans cedex 2, France 
b Rheumatology, centre hospitalier du Mans, 72037 Le Mans, France 
c Rheumatology, hôpital Sud, 35033 Rennes, France 
d Rheumatology, CHRU de Tours, 37000 Tours, France 
e Internal medicine, GFEV, 44093 Nantes, France 
f Rheumatology, CHU Hôtel-Dieu, 44093 Nantes, France 
g Rheumatology, CHU la-Cavale-Blanche, 29200 Brest, France 
h Rheumatology, CHU Pellegrin, 33000 Bordeaux, France 
i Internal medicine, CHU de Bordeaux, 33000 Bordeaux , France 
j DIM, Centre hospitalier regional d’Orleans, 45067 Orleans cedex 2, France 

Corresponding author.
Abstract
Objectives

The aims of this study in SLE population were (1) to describe ultrasonography (US) joint abnormalities, (2) to estimate the reliability of clinical swollen joint count (C-SJC) and SLEDAI (C-SLEDAI) versus US-SJC and US-SLEDAI scores, (3) to highlight specific patterns of lupus patients with Power Doppler (PD) abnormalities.

Method

For this cross-sectional multicenter study, 151 consecutive adult SLE patients were recruited. Evaluation included a clinical standardized joint assessment, B-mode and PD US of 40 joints and 26 tendons blinded for clinical examination. Reliability and agreement between clinical and B-mode US were calculated using the intraclass correlation coefficients (ICC [95% Confidence Interval]).

Results

We found a very high frequency of subclinical US abnormalities in asymptomatic patients: 85% of patients without joint symptoms had at least 1 US abnormality. Among them 46 patients (87%) had a history of joint involvement. The most frequent abnormalities were joint effusmaions (108 patients), synovial hypertrophy (SH, 109 patients) and synovitis (61 patients). Joint or tendon PD signal (grade>1) was found in 44% of patients (67/151). Synovitis were mainly located especially on MCPs and wrists. Even if reliability between clinical and grey-scale US SJC assessments was poor, reliability between clinical and US SLEDAI was good. Comparison between SLE patients with and without PD signal did not show any specific SLE pattern.

Conclusion

US may be useful to assess joint involvement in SLE patients but did not significantly change SLEDAI score.

The full text of this article is available in PDF format.

Keywords : Systemic Lupus Erythematosus, Ultrasonography, Synovitis, Rhupus




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