FRI0243 Ultrasound-Guided Synovial Biopsy Does not Alter Subsequent Ultrasound Assessments

Background Musculoskeletal ultrasound (US) is a reliable imaging tool, which complements clinical assessment of rheumatic conditions and can be used to guide a variety of interventions1. US-guided synovial biopsy (UGSB) is a minimally invasive, safe and well-tolerated procedure2 which facilitates the retrieval of synovial tissue for basic research and early phase drug development studies. Objectives To determine the impact of an USGB on the US assessment of wrist joints in RA patients prior to initiation of first-line anti-TNFα therapy. Methods At baseline all patients underwent an US assessment (Logiq9®, GE Healthcare) of both wrists followed by a unilateral UGSB (Quick-Core®, Cook Medical). US was repeated on their next visit prior to anti-TNFα administration. US scans were scored for synovial thickness (ST) and Power Doppler (PD) on a 0-3 scale for the radial, midline, and ulnar longitudinal views. Both mean scores for each wrist and the view with the maximum ST and PD score were used for analysis. The contralateral wrist was used as a control and compared to the biopsied wrist in the analysis. T-test was used to compare US measures before and after biopsy and a mixed effects model was used to assess the interaction between wrist scores. Results Twenty-nine patients (females 79%, age 57.2[25-85] years, disease duration 6.1[1-25] years, RF positive 58%, anti-CCP positive 66%, DAS28 6.29[5.1-8]) were enrolled. Mean time between the two US scans was 14.7 (8-28) days. As expected, the control wrist had lower mean ST and PD scores (p