Role of ultrasound in assessing remission in rheumatoid arthritis

Miladi Saoussen

Role of ultrasound in assessing remission in rheumatoid arthritis

Miladi Saoussen

Mongi Slim Hospital, Tunisia

: J Diagn Tech Biomed Anal

Abstract

Introduction: Remission in rheumatoid arthritis (RA) constitutes the ultimate goal of the treatment. However, the diagnosis of remission might still suffer from vagueness. Musculoskeletal Ultrasounds (US) seem to be efficient in the assessment of synovitis, effusion and bone damages. Thus, its role would be relevant, whether for diagnosis, monitoring or detecting relapses in the follow- up of RA in remission. Our goal through this literature review was to clarify the added value of ultrasonography during a state of remission. Methods: A systemic literature search was performed by Medline and Scopus. Key words used were: Rheumatoid Arthritis, remission, US. Fifty six papers were collected, then after depth analysis, twelve articles were selected for analysis. Results: Twelve papers on assessing remission in RA were identified. Remission criteria varied from an author to another. Number of joints assessed by US varied from six to 44, at least the wrist and the metacarpo-phalangeal joints of the dominant hand were scanned. Irrespective of remission criteria, all authors demonstrated that US detected Doppler positive synovitis in patients clinically in remission. Also, power Doppler synovitis predicted structural damages and future flare of RA. Conclusion: US seem to be more efficient than clinical exam. It appears to be essential when defining true remission in RA. Besides the inclusion of this technique in the new definition of remission is being validated and might be more stringent