SAT0551 Predictive Value of Ultrasonography for Radiographic Progresion in Patients with Early Rheumatoid Arthritis

BackgroundThere is a short window of opportunity for early diagnosis and treatment of rheumatoid arthritis, that may be crucial for reaching remission and a low rate of radiographic progression. High resolution power doppler ultrasonography (PDUS) is helpful in early detection of synovitis and may help to select patients at higher risk of developing structural radiographic progression of joint damage.ObjectivesTo establish whether the presence of basal power doppler signal in patients with early arthritis may be helpful in order to establish the risk of radiographic progression at 12 months of follow-up.MethodsWe studied the presence of ultrasonographic Power Doppler (PD) signal on 28 joints (shoulders, elbows, wrists, MCPs, knees) and 44 joints (28 joints and in addition hips, Tarsus, ankles and MTPs), with a mid-range equipment GE L5, in 70 patients with suspected early arthritis. The patients were included with at least one of the following inclusion criteria: a) Swelling in 2 or more joints b) pain in MCPs, MTPs and/or the wrists c) morning stiffness of more than 30 minutes with 5 mg/dl; ESR >20 mmHg) and DAS28>5.1 for each patient were registered. In 62 patients completed hands and feet radiology were available both in basal and 12 months visits. Scores according Sharp/van der Heijde method (Sharp modified method) (1) were recorded for each patient. Clinical relevant Radiographic progression was defined for each patient as a stadistical significant difference between Sharp/van der Heijde method scores in basal and 12 months visits that exceeded the SDD (smallest detectable difference) obtained from the intraobserver variability study for radiographic assessment (SDD: Erosions 2,5; narrowing 2,71; Total 2,25). Statistical study: Chi-square, Fisher exact test, p univariant and Odds Ratio calculation, SDD.ResultsThe presence of basal power doppler signal in ≥1 joints of 44 (PD44) at baseline shows statistically significant association with radiographic progression of erosions and total progression (erosions plus narrowing) at 12 months p