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Title

HAND ULTRASOUND FEATURES IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS

Background

Arthropathy can lead to disability and decrease quality of life in systemic lupus erythematosus (SLE) patients. Ultrasound (US) presents good efficacy in identification of joint injuries, even in the early stages of the disease. The prevalence of sonographic changes is still not fully known in SLE, as well as the role of US in asymptomatic patients

Materials and methods

A cross-sectional and analytical study with 30 patients (classified according to ACR and/or SLICC criteria), who underwent clinical and bilateral US high-resolution evaluation of proximal interphalangeal, metacarpophalangeal and wrists. Ultrasonographic parameters were described, in agreement with OMERACT definitions, through a semiquantitative graduation system (0-3) for evaluation of gray scale (GS) and power doppler (PD). We defined as maximum joint involvement, the highest synovitis or Doppler value found. We divided the sample asymptomatic and symptomatic subgroups according to presence of arthralgia and/or arthritis

Results

Among the included patients, 14 were classified as symptomatic and 16 as asymptomatic patients. Synovitis by GS≥1 was found in 90%, GS≥2 in 63.3% and GS=3 in 10%. The prevalence of patients with maximal synovitis (GS≥2) and maximal Doppler (PD≥2) was higher in patients with arthralgia than in the non-arthralgia group (p=0.002 and p=0.02, respectively). The majority of asymptomatic patients had non-pathological alteration (Table 1). Tenosynovitis was described in 83.3% of patients with at least one extensor compartment. Additionally, tenosynovitis(p=0.02) and erosions(p=0.01) were also more frequent in symptomatic group

Conclusions

Synovitis (GS≥2 and PD≥2), tenosynovitis and erosions were higher in patients with symptomatic SLE.

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