Abstract | OBJECTIVE: To investigate the construct validity and reliability of US DAS compared with 28-joint DAS (DAS-28) in assessing joint inflammation and in prediction of structural damage in patients with RA. METHODS: Ninety patients with active RA were prospectively recruited and followed up during the 6 months of treatment. The patients underwent clinical, laboratory and X-ray assessment, along with blinded power Doppler US (PDUS) and grey-scale (GS) US (GSUS) examination at baseline and 6 months. A subgroup of 25/90 randomly assigned patients underwent MRI examination of their hands at baseline. A PDUS examination of 22 joints and GSUS examination for effusion/ hypertrophy (E/H) of 28 joints were performed by two independent examiners, blinded to clinical findings. E/H was qualitatively assessed as absent or present, and PD signal was semi-quantitatively graded from 0 to 3. PDUS score for synovitis in 22 joints and GS score for E/H in 28 joints were included in US DAS calculation. Clinical scoring, PDUS and GSUS inter-observer reliability were evaluated. RESULTS: Strong correlation was found between US DAS and standard assessment of disease activity such as the DAS-28, ESR and CRP levels. Correlation between US DAS and patients' and physicians' visual analogue scale of activity was moderate, whereas correlations of US DAS with Health Assessment Questionnaire - Disability Index ( HAQ-DI) and Short Form 36 Health Survey (SF-36) were weak to moderate. US DAS correlated with X-ray, MRI and US parameters and rates of joint damage. CONCLUSION: US DAS better anticipated future joint damage than standard DAS-28.
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Authors | Nemanja Damjanov, Goran Radunovic, Slavica Prodanovic, Vesna Vukovic, Vera Milic, Katarina Simic Pasalic, Dragoslav Jablanovic, Srdan Seric, Sanja Milutinovic, Nikola Gavrilov |
Journal | Rheumatology (Oxford, England)
(Rheumatology (Oxford))
Vol. 51
Issue 1
Pg. 120-8
(Jan 2012)
ISSN: 1462-0332 [Electronic] England |
PMID | 22072084
(Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't, Validation Study)
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Arthritis, Rheumatoid
(diagnosis, diagnostic imaging)
- Disease Progression
- Epidemiologic Methods
- Humans
- Magnetic Resonance Imaging
(methods)
- Metacarpophalangeal Joint
(pathology)
- Middle Aged
- Observer Variation
- Physical Examination
(methods)
- Prognosis
- Severity of Illness Index
- Synovitis
(diagnosis, diagnostic imaging)
- Ultrasonography, Doppler
(methods)
- Wrist Joint
(pathology)
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