The role of ultrasonography in assessing disease activity in patients with rheumatoid arthritis and associated fibromyalgia.
OBJECTIVE
The purpose of this study is to compare and correlate US evaluation with clinical scores of the disease activity in patients with rheumatoid arthritis (RA) and concomitant fibromyalgia (FM).


METHODS
Ten patients diagnosed with RA according to the 2010 ACR/EULAR classification criteria and associated FM based on the ACR 1990 classification criteria and two control groups, one with RA (10 patients) and one with FM (10 patients), were included. Clinical assessment was performed and the disease activity scores were calculated. Synovial/tenosynovial hypertrophy, fluid collections in grey scale (GS), and Power Doppler (PD) US assessed by US in the 28 joints included in the disease activity score 28 (DAS28).


RESULTS
GS US score and PD US scores were correlated with DAS28 only in patients with RA (Pearson r coefficients 0.3 and 0.5). Mean DAS28 score was significantly higher in the RA/FM group, compared to RA and FM (5.6 versus 4.6 versus 4.5, respectively). Patients with RA/FM had similar median US scores to RA patients, while in FM group significantly lower median US scores were detected (16 versus 9.5 versus 0 for GS US and 3.5 versus 1.5 versus 0 for PD US, respectively).


CONCLUSIONS
Disease activity scores should be interpreted with caution in patients with RA and FM. When available, US should be used to guide treatment decisions in patients with RA and FM.
Rheumatology Department, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania. ghib.linda@umfcluj.ro.
Linda Jessica
LJ
Ghib
Rheumatology Department, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Maria-Magdalena
MM
Tămaş
Rheumatology Department, Clinical Emergency County Hospital, Cluj-Napoca, Romania.
Laura Otilia
LO
Damian
Rheumatology Department, Clinical Emergency County Hospital, Cluj-Napoca, Romania.
Ioana
I
Felea
Rheumatology Department, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Laura Mirela
LM
Muntean
4th Medical Department, Railway Hospital, Cluj-Napoca, Romania.
Nicolae
N
Rednic
Rheumatology Department, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Simona
S
Rednic
D001172:Arthritis, Rheumatoid / Q000150:complications / Q000000981:diagnostic imaging*; D015415:Biomarkers / Q000032:analysis; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005356:Fibromyalgia / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D008875:Middle Aged; D012720:Severity of Illness Index; D018608:Ultrasonography, Doppler
D015415:Biomarkers