title: Predictors of musculoskeletal flares and Jaccoud׳s arthropathy in patients with systemic lupus erythematosus: A 5-year prospective study.
abstract: To investigate the prognostic value of US in predicting musculoskeletal flares and Jaccoud׳s arthropathy (JA) in systemic lupus erythematosus (SLE).
  
  
  
  A total of 80 out of 94 patients (76 female; age 45.5 ± 13.2 years) with non-deforming non-erosive (NDNE) arthritis and 48/60 healthy controls (42 female; age 49.6 ± 11.6 years) completed the 5-year follow-up study. Each patient was prospectively assessed for the occurrence of musculoskeletal flares using BILAG2004 and hand deformities according to Jaccoud׳s articular index. Baseline clinical, serological, semi-quantitative (0-3 scale) ultrasound (US) findings, PD-synovitis and PD-tenosynovitis scores were used as covariates to identify predictors of study outcomes. Short Form 36 v2 (SF36v2) health survey questionnaire was administered.
  
  
  
  Overall, 12 MS flares in 10 (12.5%) patients were recorded and the incidence rate was 3.0 per 100 patient-year. Baseline PD-synovitis score independently predicted MS flare (p < 0.001; RR = 2.0; 95% CI: 1.4-3.0) within 2 years since US examination. In all, 5 (6.2%) patients developed JA whose incidence rate was 1.25 per 100 patient-year. Independent risk factors for development of JA were higher longitudinal BILAG score in the musculoskeletal domain (p = 0.005; RR = 2.4; 95% CI: 1.3-4.6) and longer disease duration (p = 0.013; RR 1.2; 95% CI: 1.1-1.3). JA and active musculoskeletal inflammation (BILAG ≥ C), but not US erosions, were associated with lower results in SF36v2 physical and mental summary components.
  
  
  
  Performing musculoskeletal US can be useful in order to predict MS flares. Jaccoud׳s deformities may arise in patients with long-standing SLE and prolonged, even subclinical, joint and tendon inflammation.
authors.affiliation: Chair of Rheumatology and Rheumatology Unit, University Clinic AOU of Cagliari, SS 554-09 042 Monserrato, Cagliari, Italy. Electronic address: matteopiga@alice.it.
authors.forename: Matteo
authors.initials: M
authors.lastname: Piga
authors.affiliation: Chair of Rheumatology and Rheumatology Unit, University Clinic AOU of Cagliari, SS 554-09 042 Monserrato, Cagliari, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Gabba
authors.affiliation: Chair of Rheumatology and Rheumatology Unit, University Clinic AOU of Cagliari, SS 554-09 042 Monserrato, Cagliari, Italy.
authors.forename: Mattia
authors.initials: M
authors.lastname: Congia
authors.affiliation: Chair of Rheumatology and Rheumatology Unit, University Clinic AOU of Cagliari, SS 554-09 042 Monserrato, Cagliari, Italy.
authors.forename: Fabiana
authors.initials: F
authors.lastname: Figus
authors.affiliation: Chair of Rheumatology and Rheumatology Unit, University Clinic AOU of Cagliari, SS 554-09 042 Monserrato, Cagliari, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Cauli
authors.affiliation: Chair of Rheumatology and Rheumatology Unit, University Clinic AOU of Cagliari, SS 554-09 042 Monserrato, Cagliari, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Mathieu
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007592:Joint Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D013585:Synovitis / Q000000981:diagnostic imaging* / Q000209:etiology; D014463:Ultrasonography
keywords: Health related quality of life; High-resolution ultrasound; Jaccoud׳s arthropathy; Musculoskeletal disorders; Prospective study; Systemic lupus erythematosus