title: Musculoskeletal ultrasonography assists the diagnostic performance of the 2010 classification criteria for rheumatoid arthritis.
abstract: OBJECTIVE
  We investigated whether musculoskeletal ultrasonography (MSKUS) assists the diagnostic performance of the 2010 rheumatoid arthritis (RA) classification criteria.
  
  
  METHODS
  Sixty-nine early arthritis patients were consecutively enrolled. None of the patients had been treated. In MSKUS of bilateral wrist and finger joints from 22 sites, the findings obtained by gray-scale and power Doppler (PD) assessment were graded on a semiquantitative scale from 0 to 3. Plain magnetic resonance imaging (MRI) of both wrist and finger joints was also examined. Diagnosis of RA was defined by the initiation of disease-modifying antirheumatic drugs within the first 3 months. The diagnostic performance of the patients was evaluated at entry using 2010 RA classification criteria in conjunction with MSKUS.
  
  
  RESULTS
  The indispensable MSKUS finding for differentiating RA was the presence of a PD grade 2 or 3 that was superior to 2010 RA classification criteria or MRI-proven bone edema. We propose that the decision tree algorithm of 2010 RA classification criteria with PD grade 2 or 3 reveals the best discriminative ability.
  
  
  CONCLUSIONS
  MSKUS, especially with a strong PD signal, is very useful to assist the diagnostic performance of the 2010 RA classification criteria in the early recognition of RA.
authors.affiliation: Department of Immunology and Rheumatology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. shin-ya@hotmail.co.jp
authors.forename: Shin-ya
authors.initials: SY
authors.lastname: Kawashiri
authors.forename: Takahisa
authors.initials: T
authors.lastname: Suzuki
authors.forename: Akitomo
authors.initials: A
authors.lastname: Okada
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamasaki
authors.forename: Mami
authors.initials: M
authors.lastname: Tamai
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakamura
authors.forename: Tomoki
authors.initials: T
authors.lastname: Origuchi
authors.forename: Akinari
authors.initials: A
authors.lastname: Mizokami
authors.forename: Masataka
authors.initials: M
authors.lastname: Uetani
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Aoyagi
authors.forename: Katsumi
authors.initials: K
authors.lastname: Eguchi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawakami
mesh_terms: D000465:Algorithms; D001172:Arthritis, Rheumatoid / Q000145:classification / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D005384:Finger Joint / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018608:Ultrasonography, Doppler / Q000379:methods*; D014955:Wrist Joint / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology