title: Ultrasonographic assessment of inflammatory activity in rheumatoid arthritis: comparison of extended versus reduced joint evaluation.
abstract: OBJECTIVE
  To investigate the validity of reduced joint counts for ultrasonographic (US) assessment of joint inflammatory activity in patients with rheumatoid arthritis (RA).
  
  
  METHODS
  Ninety-four patients with RA were included. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels were recorded for each patient. The presence of tenderness, swelling and a subjective swelling score from 0 to 3 were assessed by two rheumatologists who reached consensus in 60 joints examined in each patient. All patients underwent an US examination by a third blinded rheumatologist, using power Doppler (PD). US joint effusion, synovitis and PD signal were graded from 0 to 3 in the 60 joints. A 60-joint count and index for effusion, synovitis and PD signal were recorded. A 6-, 10-, 16-, 18-, and two 12-joint counts and indices for US parameters that included the most frequently US involved joints were calculated for each patient.
  
  
  RESULTS
  A 12-joint assessment for effusion, synovitis and PD signal, including bilateral wrist, second and third MCP, second and third PIP of hands and knee joints highly correlated with corresponding 60-joint US counts and indices. This reduced-joint US evaluation showed a similar correlation with clinical and laboratory parameters of disease activity to corresponding 60-joint assessment.
  
  
  CONCLUSIONS
  We propose that a 12-joint evaluation may be a useful tool for US assessment of overall joint inflammatory activity in RA.
authors.affiliation: Department of Rheumatology and Research Unit, Hospital de la Princesa, Madrid, Spain. esnaredo@eresmas.com
authors.forename: E
authors.initials: E
authors.lastname: Naredo
authors.forename: F
authors.initials: F
authors.lastname: Gamero
authors.forename: G
authors.initials: G
authors.lastname: Bonilla
authors.forename: J
authors.initials: J
authors.lastname: Uson
authors.forename: L
authors.initials: L
authors.lastname: Carmona
authors.forename: A
authors.initials: A
authors.lastname: Laffon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007596:Joints / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D018615:Ultrasonography, Doppler, Color / Q000379:methods*