Correlation between joint ultrasound data and clinical, laboratory and instrumental indices in patients with rheumatoid arthritis

Abstract

The aim of the investigation was to assess the correlation between the main ultrasound indices of joints and clinical, laboratory and instrumental indices in patients with rheumatoid arthritis (RA). Materials and methods. A total of 114 patients with RA underwent complex clinical, laboratory and instrumental examination, including clinical assessment of the patients’ health, according to RA activity index DAS28. Concentrations of C-reactive protein (CRP), TNF-α, anti-cyclic citrullinated peptide antibodies (ACPA), angiogenesis marker VEGF and proliferation factor FGF were measured using ELISA technique. Ultrasound examination of knee joints was carried out using ESAOTE MyLAB40 device (The Netherlands), the knee joint arthroscopy was performed using an arthroscope (Karl Storz, Germany) with a diameter of 2.4 mm and an angle of 30°. The synovial membrane samples were fixed in 10% buffered formalin solution, stained with hematoxylin and eosin and studied using Axiostar microscope (Carl Zeiss, Germany). Results. There were established statistically significant correlations between the deterioration of ultrasound indices of synovitis, synovial membrane vascularization and the increase in the markers of immune-inflammatory RA activity and VEGF marker in the blood, which indicated decline in clinical assessment of the patients’ health. The increase in ultrasound indices of synovial membrane thickness, pannus, osteochondral erosions closely correlated with the increase in RA duration, high blood levels of CRP, ACPA and FGF, which also spoke of deterioration of the clinical indices of the disease and radiographic progression of joint destruction. Conclusion. The intensity of immune-inflammatory, proliferative and destructive processes and the synovial membrane angiogenesis can be assessed by ultrasound examination of joints in RA patients. The data obtained provide the possibility of recommending the application of the non-invasive technique of synovial membrane ultrasound for diagnosis and monitoring treatment efficacy in RA patients instead of expensive invasive techniques.