title: Joint and tendon involvement in systemic lupus erythematosus: an ultrasound study of hands and wrists in 108 patients.
abstract: OBJECTIVE
  To estimate the prevalence of, and identify factors associated with, hand and wrist US alterations in a large cohort of SLE patients.
  
  
  METHODS
  One hundred and eight consecutive SLE patients were recruited and classified according to arthropathy type and the musculoskeletal item of the British Isles Lupus Assessment Group (BILAG) 2004 score. US examinations were performed on hand and wrist flexor tendons, wrist extensor tendons, second and third MCP and wrist joints bilaterally using a multi-planar scanning technique.
  
  
  RESULTS
  US examination showed joint involvement in 42/108 (38.8%) subjects, tendon involvement in 44/108 (40.7%) and both in 22/108 (20.3%). Patients with rhupus syndrome (n = 8) carried a higher incidence of inflammatory changes (87%) and erosions (87%) compared with the six with Jaccoud's arthropathy (50% and 17%, respectively) and the 94 with non-deforming X-ray non-erosive arthropathy (37% and 21%, respectively). Power Doppler signal was prevalent in patients scoring A (n = 4) or B (n = 9) on the musculoskeletal item of the BILAG 2004, and was significantly more frequent at the joint (92%) and tendon (54%) level than in the 26 patients scoring C (19%, P = 0.0007 and 15%, P = 0.016, respectively) and in the 69 scoring D (3%, P < 0.0001 and 3%, P < 0.0001). US changes in patients who scored C or D were more expressed at the tendon level (50% and 29%, respectively) than at the joint level (35% and 9%, respectively).
  
  
  CONCLUSIONS
  The picture of musculoskeletal US in SLE depends on arthropathy subtype and disease activity. US examination could be a valid and reliable tool to monitor musculoskeletal features and therapeutic outcomes in SLE patients.
authors.affiliation: Department of Rheumatology and Rheumatology Unit, University Clinic and AOU of Cagliari, Cagliari, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Gabba
authors.forename: Matteo
authors.initials: M
authors.lastname: Piga
authors.forename: Alessandra
authors.initials: A
authors.lastname: Vacca
authors.forename: Giovanni
authors.initials: G
authors.lastname: Porru
authors.forename: Pietro
authors.initials: P
authors.lastname: Garau
authors.forename: Alberto
authors.initials: A
authors.lastname: Cauli
authors.forename: Alessandro
authors.initials: A
authors.lastname: Mathieu
mesh_terms: D000328:Adult; D000367:Age Factors; D005260:Female; D006225:Hand / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D007592:Joint Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D008180:Lupus Erythematosus, Systemic / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D015588:Observer Variation; D013710:Tendons / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000473:pathology*