ArticleArthritis research & therapy2019
Significant association between joint ultrasonographic parameters and synovial inflammatory factors in rheumatoid arthritis.
Article in Arthritis research & therapy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- The preferred technique for knee synovium biopsy and synovial fluid arthrocentesis.Rheumatology international · 2023Pooled it
- Inflammation response criteria for rheumatoid arthritis based on the two-component disease activity score.RMD open · 2026Article
- Fat, flames and ultrasounds: the effects of obesity on pediatric joint inflammation.Italian journal of pediatrics · 2025Review
- Differential Diagnosis of Inflammatory Arthritis from Musculoskeletal Ultrasound View.Rheumatology and immunology research · 2022Review
- Integrating imaging and biomarker assessment to better define psoriatic arthritis and predict response to biologic therapy.Rheumatology (Oxford, England) · 2021Review
- Triptolide Inhibits Expression of Inflammatory Cytokines and Proliferation of Fibroblast-like Synoviocytes Induced by IL-6/sIL-6R-Mediated JAK2/STAT3 Signaling Pathway.Current medical science · 2021Article
- Gender Differences in Rheumatoid Arthritis: Interleukin-4 Plays an Important Role.Journal of immunology research · 2020Article
- Bioinformatics Analysis and Identification of Genes and Molecular Pathways Involved in Synovial Inflammation in Rheumatoid Arthritis.Medical science monitor : international medical journal of experimental and clinical research · 2019Article
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15 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundUltrasonography (US) can directly demonstrate joint inflammation, including grayscale (GS) signs of synovial hypertrophy and power Doppler (PD) techniques to demonstrate increased blood flow and vascularization. Recently, echogenicity, especially hypoechoic synovium, has also been associated with local inflammatory activity. However, only a few studies have demonstrated correlation between histopathologic and immunopathologic evaluation and US findings. The aim of this study was to clarify whether joint US findings including synovial hypertrophy, vascularity, and echogenicity can accurately characterize synovial pathophysiology in patients with active rheumatoid arthritis (RA).
methodsA total of 44 patients with RA were included, both treated (n = 25) and untreated (n = 19) and scheduled for US examination of the knee joint with synovial fluid (SF) aspiration and two treated patients also underwent synovial biopsy. US images were quantitatively analyzed using grayscale assessment of synovial hypertrophy and PD for vascularity and echogenicity. Levels of nine SF cytokines and growth factors were also measured.
resultsBoth US synovial hypertrophy and PD vascularity significantly correlated with SF inflammatory cytokine levels such as IL-6, IL-8, IL-1β and IL-10 in untreated patients. Angiogenic factors, including vascular endothelial growth factor (VEGF), only correlated with PD vascularity. In the treated patients, the associations between synovial hypertrophy and any cytokines were diminished, although synovial vascularity and echogenicity correlated with IL-6 and VEGF (p < 0.05). Histopathologic analysis revealed that hypoechogenicity of the synovium correlated with marked infiltration of lymphocytes and hypervascularity.
conclusionsWe demonstrated the pathophysiological origins of US findings in the joint. The degree of US vascularity of the synovium correlated with local inflammatory cytokine levels and angiogenetic factors in patients with active RA. Synovial echogenicity, and not hypertrophy, correlated with inflammation, especially in treated patients with RA.
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