title: Quantitative power Doppler ultrasound measures of peripheral joint synovitis in poor prognosis early rheumatoid arthritis predict radiographic progression.
abstract: OBJECTIVE
  To assess the value of quantitative vascular imaging by power Doppler US (PDUS) as a tool that can be used to stratify patient risk of joint damage in early seropositive RA while still biologic naive but on synthetic DMARD treatment.
  
  
  METHODS
  Eighty-five patients with seropositive RA of <3 years duration had clinical, laboratory and imaging assessments at 0 and 12 months. Imaging assessments consisted of radiographs of the hands and feet, two-dimensional (2D) high-frequency and PDUS imaging of 10 MCP joints that were scored for erosions and vascularity and three-dimensional (3D) PDUS of MCP joints and wrists that were scored for vascularity.
  
  
  RESULTS
  Severe deterioration on radiographs and ultrasonography was seen in 45 and 28% of patients, respectively. The 3D power Doppler volume and 2D vascularity scores were the most useful US predictors of deterioration. These variables were modelled in two equations that estimate structural damage over 12 months. The equations had a sensitivity of 63.2% and specificity of 80.9% for predicting radiographic structural damage and a sensitivity of 54.2% and specificity of 96.7% for predicting structural damage on ultrasonography.
  
  
  CONCLUSIONS
  In seropositive early RA, quantitative vascular imaging by PDUS has clinical utility in predicting which patients will derive benefit from early use of biologic therapy.
authors: Kennedy Institute of Rheumatology Division, Imperial College.
authors: Dee
authors: D
authors: Sreerangaiah
authors: Dianthus Medical Ltd., London.
authors: Michael
authors: M
authors: Grayer
authors: Kennedy Institute of Rheumatology Division, Imperial College.
authors: Benjamin A
authors: BA
authors: Fisher
authors: Global Medicines Development, AstraZeneca, Cheshire and.
authors: Meilien
authors: M
authors: Ho
authors: Kennedy Institute of Rheumatology Division, Imperial College.
authors: Sonya
authors: S
authors: Abraham
authors: Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK peter.taylor@kennedy.ox.ac.uk.
authors: Peter C
authors: PC
authors: Taylor
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D018450:Disease Progression; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008662:Metacarpophalangeal Joint / Q000000981:diagnostic imaging*; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013585:Synovitis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology; D018608:Ultrasonography, Doppler / Q000379:methods*; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents
keywords: early rheumatoid arthritis; treatment; ultrasonography