title: Hand and wrist arthralgia in systemic lupus erythematosus is associated to ultrasonographic abnormalities.
abstract: OBJECTIVE
  Systemic lupus erythematosus (SLE) is an autoimmune disease which may has joint impairment. Often, SLE patients complain of hand and wrist arthralgia (HA). Usually, these patients do not show any swelling in the physical exam. Our aim was to demonstrate Power Doppler Ultrasound (PDUS) abnormalities in SLE patients with HA.
  
  
  METHODS
  We recruited 58 consecutive SLE patients and divided them into two groups: case group (n = 28) were patients with HA, and control group (n = 30) were patients without HA. We also collected socio-demographic and disease activity data, biological markers and SLEDAI index. We evaluated disability and quality of life by mHAQ and SF-12, respectively. We performed a bilateral hand and wrist PDUS on all patients. PDUS findings were based in OMERACT-7 group criteria.
  
  
  RESULTS
  We found PDUS abnormalities in most of SLE patients who suffered HA, when compared to SLE controls (P < 0.001). The main findings in Case Group were: tenosynovitis (39.2%), synovial effusion or hypertrophy (25%) and active synovitis (14.2%). SLEDAI score and dsDNA antibodies were related to the presence of PDUS abnormalities (P < 0.05 and P < 0.001, respectively). We also found worse physical SF-12 (P < 0.05) and mHAQ (NS) scores in case group.
  
  
  CONCLUSIONS
  SLE patients who present HA have more PDUS abnormalities. These findings are associated with a higher SLEDAI score and dsDNA antibodies. This articular affection may contribute to a worsened functional ability and a lower quality of life. PDUS seems to be a reliable tool in the assessment of SLE patients with HA.
authors.affiliation: Rheumatology Department, Parc Salut Mar-Hospital del Mar (IMAS), Departament Medicina, Universitat Autònoma de Barcelona (UAB), C/Passeig Marítim 23-25, 08003 Barcelona, Spain. vtorrente@hsjdbcn.org
authors.forename: Vicenç
authors.initials: V
authors.lastname: Torrente-Segarra
authors.forename: Maria P
authors.initials: MP
authors.lastname: Lisbona
authors.forename: Delfí
authors.initials: D
authors.lastname: Rotés-Sala
authors.forename: Juan
authors.initials: J
authors.lastname: Muñoz-Ortego
authors.forename: Isabel
authors.initials: I
authors.lastname: Padró-Blanch
authors.forename: Joan
authors.initials: J
authors.lastname: Maymó-Guarch
authors.forename: Josep M
authors.initials: JM
authors.lastname: Manresa Domínguez
authors.forename: Jordi
authors.initials: J
authors.lastname: Carbonell-Abelló
mesh_terms: D000328:Adult; D018771:Arthralgia / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000473:pathology; D016022:Case-Control Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D050823:Hand Joints / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000473:pathology; D008875:Middle Aged; D011788:Quality of Life; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018608:Ultrasonography, Doppler; D014955:Wrist Joint / Q000000981:diagnostic imaging* / Q000473:pathology
keywords: Disability; Hand; Joint; Quality of life; Systemic lupus erythematosus; Ultrasound