Ultrasonographic evaluation of joint involvement in early XXXX in clinical remission: power Doppler signal predicts short-term relapse.

@entity1 @entity32 @entity1184 @entity603 @entity309
OBJECTIVES: This study aimed to evaluate the usefulness of a systematic musculoskeletal ultrasonographic (US) assessment in the detection of residual disease activity in @entity1 with early @entity309 who achieved clinical remission. METHODS: We prospectively studied 106 early @entity309 @entity1 receiving conventional DMARDs according to a disease activity score (DAS)-steered therapeutic protocol over a 24-month period. Standard evaluation included clinical, laboratory, functional and systematic (44 joints) US assessment. US indexes of grey scale (GS) and power Doppler (PD) @entity603 were correlated with clinical evaluation, laboratory indexes and clinical outcome. Clinical remission was defined when DAS was <1.6 at two consecutive visits 3 months apart. RESULTS: US examination was significantly more sensitive than clinical examination, both in active disease and in remission. In @entity1 with an active disease, both clinical and US indexes correlated with CRP, whereas in remission only PD still remained significantly correlated. In clinical remission, 95% of the @entity1 showed @entity603 , and 41% of them showed a positive PD signal. Positive PD signal, even in a single joint, resulted the main predictor of relapse within 6 months, both in univariable and multivariable logistic regression analysis. CONCLUSIONS: In a cohort of early @entity309 @entity1 treated with conventional DMARDs, US-GS can detect residual disease activity more sensitively than clinical examination both in active disease and in remission. Moreover, PD-positive @entity1184 identifies an ongoing @entity32 even during remission and predicts short-term relapse.
