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Influence of inflammatory polyarthritis on quantitative heel ultrasound measurements.
BMC Musculoskelet Disord. 2012 Jul 26; 13:133.BM

Abstract

BACKGROUND

There are few data concerning the impact of inflammatory polyarthritis (IP) on quantitative heel ultrasound (QUS) measurements. The aims of this analysis were i) to determine the influence of IP on QUS measurements at the heel and, ii) among those with IP to determine the influence of disease related factors on these measurements.

METHODS

Men and women aged 16 years and over with recent onset IP were recruited to the Norfolk Arthritis Register (NOAR). Individuals with an onset of joint symptoms between 1989 and 1999 were included in this analysis. At the baseline visit subjects underwent a standardised interview and clinical examination with blood taken for rheumatoid factor. A population-based prospective study of chronic disease (EPIC-Norfolk) independently recruited men and women aged 40 to 79 years from the same geographic area between 1993 and 1997. At a follow up assessment between 1998 and 2000 subjects in EPIC-Norfolk were invited to have quantitative ultrasound measurements of the heel (CUBA-Clinical) performed. We compared speed of sound (SOS) and broadband ultrasound attenuation (BUA), in those subjects recruited to NOAR who had ultrasound measurements performed (as part of EPIC-Norfolk) subsequent to the onset of joint symptoms with a group of age and sex matched non-IP controls who had participated in EPIC-Norfolk. Fixed effect linear regression was used to explore the influence of IP on the heel ultrasound parameters (SOS and BUA) so the association could be quantified as the mean difference in BUA and SOS between cases and controls. In those with IP, linear regression was used to examine the association between these parameters and disease related factors.

RESULTS

139 men and women with IP and 278 controls (mean age 63.2 years) were studied. Among those with IP, mean BUA was 76.3 dB/MHz and SOS 1621.8 m/s. SOS was lower among those with IP than the controls (difference = -10.0; 95% confidence interval (CI) -17.4, -2.6) though BUA was similar (difference = -1.2; 95% CI -4.5, +2.1). The difference in SOS persisted after adjusting for body mass index and steroid use. Among those with IP, disease activity as determined by the number of swollen joints at baseline, was associated with a lower SOS. In addition SOS was lower in the subgroup that satisfied the 1987 ACR criteria. By contrast, disease duration, steroid use and HAQ score were not associated with either BUA or SOS.

CONCLUSIONS

In this general population derived cohort of individuals with inflammatory polyarthritis there is evidence from ultrasound of a potentially adverse effect on the skeleton. The effect appears more marked in those with active disease.

Authors+Show Affiliations

Arthritis Research UK Epidemiology Unit, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK. stephen.pye@manchester.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22834652

Citation

Pye, Stephen R., et al. "Influence of Inflammatory Polyarthritis On Quantitative Heel Ultrasound Measurements." BMC Musculoskeletal Disorders, vol. 13, 2012, p. 133.
Pye SR, Marshall T, Gaffney K, et al. Influence of inflammatory polyarthritis on quantitative heel ultrasound measurements. BMC Musculoskelet Disord. 2012;13:133.
Pye, S. R., Marshall, T., Gaffney, K., Luben, R., Khaw, K. T., Silman, A. J., Symmons, D. P., & O'Neill, T. W. (2012). Influence of inflammatory polyarthritis on quantitative heel ultrasound measurements. BMC Musculoskeletal Disorders, 13, 133. https://doi.org/10.1186/1471-2474-13-133
Pye SR, et al. Influence of Inflammatory Polyarthritis On Quantitative Heel Ultrasound Measurements. BMC Musculoskelet Disord. 2012 Jul 26;13:133. PubMed PMID: 22834652.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influence of inflammatory polyarthritis on quantitative heel ultrasound measurements. AU - Pye,Stephen R, AU - Marshall,Tarnya, AU - Gaffney,Karl, AU - Luben,Robert, AU - Khaw,Kay-Tee, AU - Silman,Alan J, AU - Symmons,Deborah P M, AU - O'Neill,Terence W, Y1 - 2012/07/26/ PY - 2011/11/22/received PY - 2012/07/05/accepted PY - 2012/7/28/entrez PY - 2012/7/28/pubmed PY - 2012/12/14/medline SP - 133 EP - 133 JF - BMC musculoskeletal disorders JO - BMC Musculoskelet Disord VL - 13 N2 - BACKGROUND: There are few data concerning the impact of inflammatory polyarthritis (IP) on quantitative heel ultrasound (QUS) measurements. The aims of this analysis were i) to determine the influence of IP on QUS measurements at the heel and, ii) among those with IP to determine the influence of disease related factors on these measurements. METHODS: Men and women aged 16 years and over with recent onset IP were recruited to the Norfolk Arthritis Register (NOAR). Individuals with an onset of joint symptoms between 1989 and 1999 were included in this analysis. At the baseline visit subjects underwent a standardised interview and clinical examination with blood taken for rheumatoid factor. A population-based prospective study of chronic disease (EPIC-Norfolk) independently recruited men and women aged 40 to 79 years from the same geographic area between 1993 and 1997. At a follow up assessment between 1998 and 2000 subjects in EPIC-Norfolk were invited to have quantitative ultrasound measurements of the heel (CUBA-Clinical) performed. We compared speed of sound (SOS) and broadband ultrasound attenuation (BUA), in those subjects recruited to NOAR who had ultrasound measurements performed (as part of EPIC-Norfolk) subsequent to the onset of joint symptoms with a group of age and sex matched non-IP controls who had participated in EPIC-Norfolk. Fixed effect linear regression was used to explore the influence of IP on the heel ultrasound parameters (SOS and BUA) so the association could be quantified as the mean difference in BUA and SOS between cases and controls. In those with IP, linear regression was used to examine the association between these parameters and disease related factors. RESULTS: 139 men and women with IP and 278 controls (mean age 63.2 years) were studied. Among those with IP, mean BUA was 76.3 dB/MHz and SOS 1621.8 m/s. SOS was lower among those with IP than the controls (difference = -10.0; 95% confidence interval (CI) -17.4, -2.6) though BUA was similar (difference = -1.2; 95% CI -4.5, +2.1). The difference in SOS persisted after adjusting for body mass index and steroid use. Among those with IP, disease activity as determined by the number of swollen joints at baseline, was associated with a lower SOS. In addition SOS was lower in the subgroup that satisfied the 1987 ACR criteria. By contrast, disease duration, steroid use and HAQ score were not associated with either BUA or SOS. CONCLUSIONS: In this general population derived cohort of individuals with inflammatory polyarthritis there is evidence from ultrasound of a potentially adverse effect on the skeleton. The effect appears more marked in those with active disease. SN - 1471-2474 UR - https://www.unboundmedicine.com/medline/citation/22834652/Influence_of_inflammatory_polyarthritis_on_quantitative_heel_ultrasound_measurements_ L2 - https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/1471-2474-13-133 DB - PRIME DP - Unbound Medicine ER -