Definition and Reliability Assessment of Elementary Ultrasonographic Findings in Calcium Pyrophosphate Deposition Disease: A Study by the OMERACT Calcium Pyrophosphate Deposition Disease Ultrasound Subtask Force (original) (raw)
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Poster Presentations, 2017
0 bursae. Ultrasound abnormalities were found in 62 joints, 73 tendons, 8 bursae, 0 entheses. Overall physical examination and MSUS showed good concordance even if MSUS was more sensitive especially in detecting extra-articular locations. Conclusions: If the extra-articular locations of synovitis are taken in consideration during the ultrasound examination, there is a good sensitivity of MSUS and a better concordance between clinical and MSUS assessment of JIA. MSUS seems more accurate than physical assessment in detecting the exact position of the inflamed synovial membrane in each anatomical location (joint, synovial sheath, synovial bursa). It could be helpful not only for better addressing the injective procedures, but also for a global quantification of the synovitis (both intra and extra-articular), even if the exact clinical meaning of these ultrasound findings is still unknown, in terms of response to treatments and prognosis.
Annals of the Rheumatic Diseases, 2016
The t-GS score of the shoulder joint was significantly higher in the anti-CCP negative group than in the positive group (4.6 ± 2.0 and 2.8 ± 2.5, respectively, p<0.05). However, the remainder of the examined joints showed no significant differences. Furthermore, no significant differences were observed between the two groups in terms of the t-PD scores of all joints. In EORA patients, the t-GS and t-PD scores of the shoulder joint strongly correlated with the HAQ score (r=0.72, p<0.0001, r=0.68, p<0.0001, respectively) and, among the shoulder joint components, long head biceps tendon showed the strongest correlation both in the t-GS and t-PDS scores (r=0.64, p<0.0001, r=0.55, p<0.001). The t-PD scores of the shoulder, wrist, and MP joints correlated with DAS 28-ESR (r=0.62, p<0.0001, r=0.43, p<0.05, r=0.38, p<0.05). Conclusions: Shoulder joint involvement was a specific feature in patients with EORA and contributed to functional disability and increased disease activity. References: [1] Soubrier et al. Elderly-onset rheumatoid arthritis.
Arthritis Care & Research, 2014
To determine the sensitivity, specificity, and accuracy of ultrasound (US) in the detection of cartilage calcification at knee level in patients with calcium pyrophosphate deposition disease (CPDD) and to assess the interobserver reliability. Methods. Seventy-four CPDD patients and 83 controls with other chronic arthritis were included. All patients underwent a clinical examination, synovial fluid analysis, and radiographic assessment of the knee. US examinations were performed in order to detect hyperechoic spots within the hyaline cartilage layer and hyperechoic areas within the meniscal fibrocartilage. Twenty patients were assessed by 2 operators in order to calculate the interobserver reliability.
Annals of the Rheumatic Diseases, 2015
in target tophus area (measured using Vernier calipers) was assessed over the duration of the study. Patients were categorized by on-study median sUA levels of ≥6, 5-<6, 4-<5, 3-<4, and <3 mg/dL. On-study median sUA is defined as the median of an individual subject's scheduled post-baseline sUA measurements, regardless of number of post-baseline measurements present. Results: In total, 1537 patients were eligible for analysis; 95% were male, 78% were white, and mean (SD) age was 42 (11) years. A total of 474 patients (30.8%) had ≥1 target tophi that were followed in the studies. A positive relationship between lower sUA and greater tophus area reduction and GFRT was observed. In patients with ≥1 target tophi at baseline in the 3 studies, those with lowest on-study median sUA levels achieved greatest reduction in tophus area (Fig. 1A). Patients with median sUA <3.0 mg/dL had ∼60% mean reduction in tophus area at Month 12 compared with 28% for those with sUA of 5.0-<6.0 mg/dL. Similarly, those with lower sUA levels were less likely to have GFRT. During the last quarter of the study, 12.2% with median sUA <3.0 mg/dL experienced a GFRT, compared with 20.5% with median sUA of 5.0-<6.0 mg/dL (Fig. 1B). Conclusions: These findings demonstrate that degree of clinical benefit (reduction in GFRT or tophus area) within 12 months correlates with the magnitude of sustained sUA lowering using oral sUA-lowering therapy. The results provide additional confirmation of the validity of sUA lowering as a surrogate for clinically meaningful effects in gout patients and point to potential benchmarks. In this context, patients with median sUA <3.0 mg/dL had approximately double the mean reduction in tophus area at Month 12 compared with sUA 5.0-<6.0 mg/dL and approximately 40% lower GFRT in the last quarter of the study. Acknowledgements: This study was funded by Ardea Biosciences/AstraZeneca. Editorial support was provided by PAREXEL and was funded by AstraZeneca.
Clinical and ultrasound findings in patients with calcium pyrophosphate dihydrate deposition disease
Medical ultrasonography, 2018
To evaluate the presence and distribution of calcium pyrophosphate (CPP) deposits in joints commonly affected by CPP deposition (CPPD) disease (acromio-clavicular, gleno-humeral, wrists, hips, knees, ankles, and symphysis pubis joints) using ultrasound (US). Thirty consecutive patients fulfilling McCarty diagnostic criteria for CPPD were consecutively enrolled in the study. The data registered using the US included the affected joints, the calcification site, and the pattern of calcification (thin hyperechoic bands, parallel to the surface of the hyaline cartilage, hyperechoic spots, and hyperechoic nodular or oval deposits). The presence of CPP crystals in knees was confirmed by polarized light microscopy examination of the synovial fluid and radiographs of the knees were performed in all patients. In 30 patients, 390 joints were scanned, (13 joints in every patient). The mean±standard deviation number of joints with US CPPD evidence per patient was 2.93±1.8 (range 1-9). The knee w...
Annals of the Rheumatic Diseases, 2005
Objective: To investigate by high frequency ultrasonography the appearance of calcium pyrophosphate dihydrate (CPPD) calcifications, in the most commonly affected sites in CPPD disease, and the relationship between ultrasonographic CPPD deposits and the presence of CPPD crystals in synovial fluid. Methods: Three ultrasonographic patterns of CPPD calcification were identified and 11 patients enrolled. A control group comprised 13 patients with no evidence of CPPD deposits. Synovial fluid was aspirated from all patients and controls and examined for identification of crystals. All patients underwent a standard radiography examination at the same sites investigated by ultrasound. Results: In all patients with ultrasonographically defined CPPD deposits, CPPD crystals were found in the synovial fluid. In two cases, standard radiographic examination did not show evidence of the calcific deposits that were identified by ultrasonography. CPPD crystals were not found in the synovial fluid of controls. In four control group patients, ultrasonography identified calcifications defined as deposits of another nature. Conclusions: The ultrasonographic pattern used in this study for the diagnosis of CPPD disease demonstrated a very high correlation with the presence of CPPD crystals in synovial fluid. Ultrasonography demonstrated a sensitivity and specificity at least equal to that of radiography in identifying CPPD crystal calcifications.
Clinical and experimental rheumatology
The knee is a frequent target for gout and calcium pyrophosphate dihydrate (CPPD) disease with involvement of both articular and peri-articular structures. The aims of the present study were to investigate the relationship between clinical and ultrasound (US) findings and to describe the prevalence and distribution of crystal deposits in the knee in patients with gout and CPPD disease. Thirty patients with gout and 70 patients with CPPD disease were enrolled in the study. Prior to US assessment all patients underwent a clinical examination by an expert rheumatologist who recorded the presence/absence of pain, tenderness (evocated by palpation and/or active or passive mobilisation of the knee), and knee swelling. US examinations were performed using a Logiq 9 (General Electric Medical Systems, Milwaukee, WI) equipped with a multifrequency linear probe, working at 9 MHz. Two hundred knee joints were investigated in a total of 100 patients. Fifty-one (25.5%) knee joints were found clin...