ArticleBMC musculoskeletal disorders2017
Joint-specific assessment of swelling and power Doppler in obese rheumatoid arthritis patients.
Article in BMC musculoskeletal disorders, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 38 citations in OpenAlex.
- EULAR points to consider for the management of difficult-to-treat rheumatoid arthritis.Annals of the rheumatic diseases · 2022Guideline
- Pooled it
- Obesity is a risk factor for poor response to treatment in early rheumatoid arthritis: a NORD-STAR study.RMD open · 2024Trial
- Dosing Biologic Drugs for Patients With Obesity: One Size Does Not Fit All.Arthritis & rheumatology (Hoboken, N.J.) · 2026Article
- Location and amount of joint involvement differentiates rheumatoid arthritis into different clinical subsets.NPJ digital medicine · 2025Article
- Musculoskeletal ultrasonography versus conventional radiography: Correlation with DAS28 and MDHAQ scores in early rheumatoid arthritis.The Journal of international medical research · 2024Article
- Impact of multimorbidity on the first ts/bDMARD effectiveness and retention rate after two years of follow-up in patients with rheumatoid arthritis from the BIOBADASER registry.Arthritis research & therapy · 2024Article
- Patients with clinically diagnosed hand OA not fulfilling the ACR classification criteria are in an earlier disease phase and more often have thumb base OA.Osteoarthritis and cartilage open · 2023Article
- Association Between Power Doppler Ultrasound Signals and Chronic Pain After Total Knee Arthroplasty: A Cross-Sectional Explorative Study.Journal of pain research · 2023Article
- The role of comorbidities alongside patient and disease characteristics in long-term disease activity in RA using UK inception cohort data.Rheumatology (Oxford, England) · 2022Article
- Doppler ultrasound impacts response to intravenous tocilizumab in rheumatoid arthritis patients.Clinical rheumatology · 2021Article
- Sentinel joint scoring in rheumatoid arthritis: an individualized power Doppler assessment strategy.Clinical rheumatology · 2021Article
- The Impact of Obesity on Disease Activity and Treatment Response in Rheumatoid Arthritis.Current rheumatology reports · 2020Review
- Doubtful swelling on clinical examination reflects synovitis in rheumatoid arthritis.Therapeutic advances in musculoskeletal disease · 2020Article
- Ultrasound and multi-biomarker disease activity score for assessing and predicting clinical response to tofacitinib treatment in patients with rheumatoid arthritis.BMC rheumatology · 2020Article
- Obesity Impacts Swelling of Ankle and Foot Joints in Early Rheumatoid Arthritis Patients.Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases · 2019Article
- Sonographic appearance of fluid in peripheral joints and bursae of healthy asymptomatic Chinese population.Quantitative imaging in medicine and surgery · 2018Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundClinical swollen joint examination of the obese rheumatoid arthritis (RA) patient can be difficult. Musculoskeletal Ultrasound (MSUS) has higher sensitivity than physical examination for swollen joints (SJ). The purpose of this study was to determine the joint-specific association between power Doppler (PDUS) and clinical SJ in RA across body mass index (BMI) categories.
methodsCross-sectional clinical and laboratory data were collected on 43 RA patients. PDUS was performed on 9 joints (wrist, metacarpalphalangeal 2-5, proximal interphalgeal 2/3 and metatarsalphalangeal 2/5). DAS28 and clinical disease activity index (CDAI) were calculated. Patients were categorized by BMI: <25, 25-30, and >30. Demographic and clinical characteristics were compared across BMI groups with Kruskal-Wallis test and chi-square tests. Joint-level associations between PDUS and clinically SJ were evaluated with mixed effects logistic regression models.
resultsWhile demographics and clinically-determined disease activity were similar among BMI groups, PDUS scores significantly differed (p = 0.02). Using PDUS activity as the reference standard for synovitis and clinically SJ as the test, the positive predictive value of SJ was significantly lower in higher BMI groups (0.71 in BMI < 25, 0.58 in BMI 25-30 and 0.44 in BMI < 30) (p = 0.02). The logistic model demonstrated that increased BMI category resulted in decreased likelihood of PDUS positivity (OR 0.52, p = 0.03).
conclusionsThis study suggests that in an obese RA patient, a clinically assessed SJ is less likely to represent true synovitis (as measured by PDUS). Disease activity in obese RA patients may be overestimated by CDAI/DAS28 calculations and clinicians when considering change in therapy.
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