title: Arthritis of the Knee Joint in Rheumatoid Arthritis - Evaluation of Treatment Response by Ultrasound in Daily Clinical Practice.
abstract: BACKGROUND
  Rheumatoid arthritis (RA) commonly involves the knee joint in up to 30% of patients. Musculoskeletal ultrasound enables the skilled clinician to easily assess disease activity.
  
  
  OBJECTIVE
  To evaluate the sensitivity to change of the sonography score of large joints in Rheumatology (SOLAR) for different treatments of knee arthritis in RA.
  
  
  METHODS
  Joints were assessed by ultrasound at 4 visits. Laboratory, immunological and clinical parameters were recorded.
  
  
  RESULTS
  225 RA patients were analyzed. The DAS 28 in the subgroup receiving systemic steroids was significantly higher (p < 0.001) than in patients treated with intraarticular glucocorticosteroids (GCs) at T0, comparing the values from T0 to T3 the same appeared (p=0.003). Concerning the acute GC treatment regimens, the gray scale ultrasound (GSUS) sum score was found to be significantly higher in patients receiving intraarticular GCsversusno GCs (p=0,035), as well as in patients receiving systemicversusintraarticular GCs (p=0.001). Regarding the differences from T0 and T3, similar to the baseline analysis, a high GSUS sum score was significantly associated with intraarticular GCs, a low to no GC administration (p=0.035), while a high GSUS sum score was significantly linked to intraarticular GCs, rather than systemic GCs (p=0.008).
  
  
  CONCLUSIONS
  SOLAR score is sensitive to change in knee arthritis. Intraarticular GC administration is performed in patients with high GSUS scores. Systemic administration of GC is linked to high disease activity (DAS28) rather than GSUS or power Doppler ultrasound (PDUS) results.
authors.affiliation: Immanuel Krankenhaus Berlin, Medical Centre for Rheumatology and Clinical Immunology Berlin-Buch, Lindenberger Weg 19, 13125 Berlin, Germany.
authors.forename: V S
authors.initials: VS
authors.lastname: Schäfer
authors.affiliation: Immanuel Krankenhaus Berlin, Medical Centre for Rheumatology and Clinical Immunology Berlin-Buch, Lindenberger Weg 19, 13125 Berlin, Germany.
authors.forename: W A
authors.initials: WA
authors.lastname: Schmidt
authors.affiliation: Department of Internal Medicine, Park-Klinik Weißensee, Rheumatology and Clinical Immunology, Schönstraße 80, 13086 Berlin, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Backhaus
authors.affiliation: Department of Rheumatology and Clinical Immunology, Asklepios Clinic, Kaiser- Karl-V.-Allee 3, Bad Abbach, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Hartung
keywords: Glucocorticosteroids; Knee joint; Musculoskeletal ultrasound; Nonsteroidal anti-inflammatory drugs; Rheumatoid arthritis; Therapy; Ultrasound