Evidence map›Paper›PMID 31028442›Full record

ArticleEuropean radiology2019

Real benefits of ultrasound evaluation of hand and foot synovitis for better characterisation of the disease activity in rheumatoid arthritis.

Coziana Ciurtin, Alexis Jones, Geraint Brown, Fang En Sin, Charles Raine, Jessica Manson, Ian Giles

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European radiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Review
  8. Ultrasound in the evaluation of rheumatoid arthritis.European journal of rheumatology · 2022
    Article
  9. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Coziana CiurtinDepartment of Rheumatology, University College London Hospitals NHS Trust, 250 Euston Road, London, NW1 2PG, UK. c.ciurtin@ucl.ac.uk.
Alexis JonesDepartment of Rheumatology, University College London Hospitals NHS Trust, 250 Euston Road, London, NW1 2PG, UK.
Geraint BrownDepartment of Rheumatology, University College London Hospitals NHS Trust, 250 Euston Road, London, NW1 2PG, UK.
Fang En SinDepartment of Rheumatology, University College London Hospitals NHS Trust, 250 Euston Road, London, NW1 2PG, UK.
Charles RaineDepartment of Rheumatology, University College London Hospitals NHS Trust, 250 Euston Road, London, NW1 2PG, UK.
Jessica MansonDepartment of Rheumatology, University College London Hospitals NHS Trust, 250 Euston Road, London, NW1 2PG, UK.
Ian GilesDepartment of Rheumatology, University College London Hospitals NHS Trust, 250 Euston Road, London, NW1 2PG, UK.
University College London Hospitals NHS Foundation Trust · GBUniversity College London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesOptimal management of rheumatoid arthritis (RA) depends on accurate evaluation of disease activity. Foot synovitis is not included in the most used RA outcome measure (DAS-28 score). The aim of this study was to investigate how musculoskeletal ultrasound (MSK-US) examination of hand and feet correlate with the disease activity score (DAS-28 score). We also explored whether performing MSK-US assessments of hands alone compared with hands and feet underestimates the disease activity in RA.

methodsThis is a real-life cross-sectional study of 101 patients (51 with RA and 50 with other musculoskeletal conditions) with inflammatory small joint pain, who underwent MSK-US examination of hands and feet.

resultsMSK-US-detected hand synovitis was found in 18/51 (35.3%) RA patients and 16/50 (32%) of those with other musculoskeletal conditions (p = 0.96), while foot synovitis was detected in 18/51 (35.3%) and 12/50 (24%) patients, respectively (p = 0.78). DAS-28 did not correlate with any of the US outcome measures in patients with RA. Six out of 13 (46.1%) RA patients in remission, 7/14 (50%) with low disease activity and 18/32 (56.2%) with moderate disease activity (according to DAS-28 definition) had active synovitis as assessed by the MSK-US examination of their hands and feet. MSK-US-detected synovitis led to treatment escalation in 26/51 (51%) RA patients.

conclusionThis study emphasises that MSK-US examination of hands and feet has led to optimised management of the majority of RA patients, which would have not been possible otherwise, because of the lack of correlation between DAS-28 assessment and MSK-US outcomes. KEY POINTS: • The most used disease activity score in rheumatoid arthritis (DAS-28) did not correlate with US outcome measures derived from hands and feet examination. • DAS-28 did not differentiate between RA patients with subclinical active synovitis versus well-controlled disease on US. • As a result of US examination of the hands and feet, 51% RA patients had their immunosuppressive treatment optimised.

Indexed as

Ultrasonography, DopplerAdultAgedArthritis, RheumatoidCross-Sectional StudiesFemaleFootHandHumansMaleMiddle AgedSynovitisDoppler ultrasoundOutcome measuresRheumatoid arthritisSynovitis

Identifiers

PMID31028442
PMCPMC6795612
OpenAlexW2940924169

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.