title: Structural damage in rheumatoid arthritis: comparison between tendon damage evaluated by ultrasound and radiographic damage.
abstract: OBJECTIVE
  To compare structural damage assessed by conventional radiography and tendon damage assessed by musculoskeletal US (MSUS) at wrist and ankle in RA patients.
  
  
  METHODS
  We evaluated 72 consecutive patients [56 (77.8%) females] with RA. The MSUS evaluation consisted in a B-mode examination of bilateral extensor carpi ulnaris and tibialis posterior tendons. Tendon damage was defined and scored according to OMERACT. A total score for the tendon damage score (TDS) was calculated by summing the grades for each tendon. For the radiographic evaluations we used the van der Heijde score; a total radiographic score (RTS) was calculated by summing a bone erosion score (ERS) and a joint space narrowing score (JSNS).
  
  
  RESULTS
  We evaluated 288 tendons. The mean (s.d.) of TDS was 2.3 (1.8). Fifty-four (75%) patients presented tendon damage of at least one tendon. From all evaluated tendons, 134 (46.5%) had no tendon damage, 146 (50.7%) had grade 1 and 8 (2.8%) had grade 2 tendon damage. The mean (s.d.) for RTS was 91.4 (97), for ERS was 47.3 (61.9) and for JSNS was 44.1 (37.2). We found a significant correlation between disease duration and both TDS and RTS (r = 0.413 and r = 0.560, respectively; P < 0.0001). We found a good significant correlation between TDS and all variables of radiographic structural damage (RTS, r = 0.65; ERS, r = 0.637; JSNS, r = 0.618; P < 0.001).
  
  
  CONCLUSIONS
  The MSUS assessment of only four tendons can be an additional feasible method to assess structural damage in RA patients.
authors.affiliation: Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain and iustinajanta@yahoo.com.
authors.forename: Iustina
authors.initials: I
authors.lastname: Janta
authors.affiliation: Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain and Clinical Center of Rheumatic Diseases 'Dr Ion Stoia', Bucharest, Romania.
authors.forename: Denisa
authors.initials: D
authors.lastname: Stanciu
authors.affiliation: Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain and.
authors.forename: Michelle
authors.initials: M
authors.lastname: Hinojosa
authors.affiliation: Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain and.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Nieto-González
authors.affiliation: Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain and.
authors.forename: Lara
authors.initials: L
authors.lastname: Valor
authors.affiliation: Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain and.
authors.forename: Natalia
authors.initials: N
authors.lastname: Bello
authors.affiliation: Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain and.
authors.forename: Belen
authors.initials: B
authors.lastname: Serrano
authors.affiliation: Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain and.
authors.forename: Carmen
authors.initials: C
authors.lastname: Mata-Martínez
authors.affiliation: Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain and.
authors.forename: Julia
authors.initials: J
authors.lastname: Martínez-Barrio
authors.affiliation: Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain and.
authors.forename: Juan Gabriel
authors.initials: JG
authors.lastname: Ovalles-Bonilla
authors.affiliation: Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain and.
authors.forename: Carlos Manuel
authors.initials: CM
authors.lastname: González
authors.affiliation: Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain and.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: López-Longo
authors.affiliation: Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain and.
authors.forename: Indalecio
authors.initials: I
authors.lastname: Monteagudo
authors.affiliation: Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain and.
authors.forename: Esperanza
authors.initials: E
authors.lastname: Naredo
authors.affiliation: Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain and.
authors.forename: Luis
authors.initials: L
authors.lastname: Carreño
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000842:Ankle / Q000000981:diagnostic imaging / Q000473:pathology; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000473:pathology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography / Q000379:methods / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D013710:Tendons / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography / Q000379:methods / Q000706:statistics & numerical data; D014953:Wrist / Q000000981:diagnostic imaging / Q000473:pathology
keywords: rheumatoid arthritis; structural damage; tendon; tendon damage; ultrasound