Assessment of both articular synovitis and tenosynovitis by ultrasound is useful for evaluations of hand dysfunction in early rheumatoid arthritis patients.
OBJECTIVE
We investigated the association between hand dysfunction and ultrasound (US)-detected articular synovitis and tenosynovitis in patients with rheumatoid arthritis (RA).


METHODS
Thirty RA patients were examined. In both hands of all subjects, articular synovitis and tenosynovitis were assessed by US at 22 joints and 12 tendons. Each joint and tendon was scored by gray-scale (GS) and power Doppler (PD) on a scale from 0 to 3. The sums of the GS or PD scores were used as the articular synovitis score and the tenosynovitis score. The sum of the articular synovitis and tenosynovitis scores was used as the combined US score. Hand dysfunction was evaluated by a grip-Health Assessment Questionnaire (HAQ) and visual analog scale of morning stiffness (MS-VAS). We used Spearman's correlation coefficient to determine the relationships among the US scores, the two hand dysfunction indices, and the DAS28-ESR.


RESULTS
The articular synovitis scores were significantly correlated with grip-HAQ (GS: rs= 0.47, p = 0.009, PD: rs= 0.48, p = 0.006), but not with MS-VAS. The tenosynovitis scores were correlated with MS-VAS (GS: rs= 0.38, p = 0.039, PD: rs= 0.36, p = 0.053), but not with grip-HAQ. Both grip-HAQ (GS: rs= 0.53, p = 0.002, PD: rs= 0.55, p = 0.001) and the MS-VAS (GS: rs= 0.39, p = 0.031, PD: rs= 0.47, p = 0.008) were correlated with the combined US scores.


CONCLUSIONS
The US scores combined with articular synovitis and tenosynovitis scores well reflect the severity of hand dysfunction in early-stage RA patients.
a Department of Immunology and Rheumatology.|b Department of Center for Comprehensive Community Care Education.
Ayako
A
Nishino
a Department of Immunology and Rheumatology.|c Department of Public Health.|d Department of Community Medicine , and.
Shin-Ya
SY
Kawashiri
a Department of Immunology and Rheumatology.
Toshimasa
T
Shimizu
a Department of Immunology and Rheumatology.
Masataka
M
Umeda
a Department of Immunology and Rheumatology.
Shoichi
S
Fukui
a Department of Immunology and Rheumatology.
Tomohiro
T
Koga
a Department of Immunology and Rheumatology.
Naoki
N
Iwamoto
a Department of Immunology and Rheumatology.
Kunihiro
K
Ichinose
a Department of Immunology and Rheumatology.
Mami
M
Tamai
a Department of Immunology and Rheumatology.
Hideki
H
Nakamura
e Department of Health Sciences , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan.
Tomoki
T
Origuchi
b Department of Center for Comprehensive Community Care Education.
Yasuhiro
Y
Nagata
d Department of Community Medicine , and.
Takahiro
T
Maeda
c Department of Public Health.
Kiyoshi
K
Aoyagi
a Department of Immunology and Rheumatology.
Atsushi
A
Kawakami
D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006225:Hand / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D007596:Joints / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D013585:Synovitis / Q000000981:diagnostic imaging* / Q000209:etiology; D013717:Tenosynovitis / Q000000981:diagnostic imaging* / Q000209:etiology; D014463:Ultrasonography / Q000379:methods*; D064232:Visual Analog Scale
Articular synovitis; Hand dysfunction; Rheumatoid arthritis; Tenosynovitis; Ultrasound