title: Comparison of ultrasonographic joint and tendon findings in hands between early, treatment-naïve patients with systemic lupus erythematosus and rheumatoid arthritis.
abstract: Although both systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) may lead to joint deformity, SLE arthritis is typically non-erosive and often accompanied by Jaccoud's deformity. Therefore, we examined characteristics of joint and tendon lesions in patients with SLE and RA by ultrasonography. Fifteen treatment-naïve SLE patients and 40 treatment-naïve RA patients with joint symptoms were included in this study. The hand joints and related tendons were ultrasonographically examined using grey-scale (GS) and power Doppler (PD). Joint involvement was comparably observed in patients with SLE and RA (80% versus 95%, p = 0.119). However, tendon involvement was more frequent in SLE than in RA (93% versus 65%, p = 0.045), especially in the wrist joints (73% versus 40%, p = 0.037). When we investigated the intensity of US findings, the joint synovitis score (GS + PD) per affected joint was lower in SLE than RA (2.0 versus 2.6, p = 0.019), while tendon inflammation score was not significantly different (2.1 versus 2.2, p = 0.738). Finally, the examination of concordance between joint and tendon involvement in the same finger revealed that joint lesion appeared in only 49% of fingers having tendon involvement in the SLE group, which was significantly less than 74% in the RA group ( p = 0.010). Thus, as compared with RA, SLE arthropathy is characterized by the predominance of tenosynovitis/periextensor tendon inflammation, which is likely to develop independently from joint synovitis.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Ogura
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Hirata
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Hayashi
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Takenaka
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Ito
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Mizushina
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Fujisawa
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Imamura
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Yamashita
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Nakahashi
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Kujime
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kameda
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006225:Hand / Q000000981:diagnostic imaging*; D006801:Humans; D007249:Inflammation / Q000000981:diagnostic imaging / Q000209:etiology; D008180:Lupus Erythematosus, Systemic / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013585:Synovitis / Q000000981:diagnostic imaging / Q000209:etiology; D013710:Tendons / Q000000981:diagnostic imaging*; D013717:Tenosynovitis / Q000000981:diagnostic imaging / Q000209:etiology; D018608:Ultrasonography, Doppler / Q000379:methods; D014955:Wrist Joint / Q000000981:diagnostic imaging
keywords: Rheumatoid arthritis; joint synovitis; systemic lupus erythematosus; tenosynovitis; ultrasonography