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The additional benefit of ultrasonography to 2010 ACR/EULAR classification criteria when diagnosing rheumatoid arthritis in the absence of anti-cyclic citrullinated peptide antibodies.
Clin Rheumatol. 2017 Feb; 36(2):261-267.CR

Abstract

The aim of this study was to assess the benefit of ultrasonography (US) contributing to 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria in diagnosing rheumatoid arthritis (RA), when anti-citrullinated protein (CCP) antibody and radiographic erosions are absent. Ninety-four patients suffering from arthritis of at least one joint in hands, symptom duration of less than 2 years, normal radiographs at baseline, and negative anti-CCP had 22 joint US assessments and were followed prospectively for at least 12 months. Sensitivity and specificity for final RA diagnosis based on 1987 RA criteria were determined for ultrasound variables. Logistic regression models were then fitted to evaluate predictive ability over and above the 2010 ACR/EULAR classification criteria. Twenty-nine of them were classified as RA patients and 65 had alternative diagnoses. There were significantly more joints with synovial hypertrophy, synovitis, and bone erosion detected by US in RA patients. The gray-scale (GS) variables positively correlated with acute phase reactants. The area under curve (AUC) values of GS and power Doppler (PD) were comparable, higher than bone erosion. However, regression analysis demonstrated that only PD involvement of joints, especially wrists, provided independently predictive data, with improved AUC values from 0.738 to 0.872 combined with 2010 ACR/EULAR classification criteria. PD scanning of hand joints, especially wrists, may provide independently assistance to 2010 ACR/EULAR criteria in the early diagnosis of RA in those patients who are negative for anti-CCP antibody.

Authors+Show Affiliations

Department of Rheumatology and Clinical Immunology, Peking University First Hospital, No.8 Xishiku Street, West District, Beijing, 100034, China.Department of Rheumatology and Clinical Immunology, Peking University First Hospital, No.8 Xishiku Street, West District, Beijing, 100034, China.Department of Rheumatology and Clinical Immunology, Peking University First Hospital, No.8 Xishiku Street, West District, Beijing, 100034, China.Department of Rheumatology and Clinical Immunology, Peking University First Hospital, No.8 Xishiku Street, West District, Beijing, 100034, China.Department of Rheumatology and Clinical Immunology, Peking University First Hospital, No.8 Xishiku Street, West District, Beijing, 100034, China. zhuoli.zhang@126.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27848057

Citation

Ji, Lanlan, et al. "The Additional Benefit of Ultrasonography to 2010 ACR/EULAR Classification Criteria when Diagnosing Rheumatoid Arthritis in the Absence of Anti-cyclic Citrullinated Peptide Antibodies." Clinical Rheumatology, vol. 36, no. 2, 2017, pp. 261-267.
Ji L, Deng X, Geng Y, et al. The additional benefit of ultrasonography to 2010 ACR/EULAR classification criteria when diagnosing rheumatoid arthritis in the absence of anti-cyclic citrullinated peptide antibodies. Clin Rheumatol. 2017;36(2):261-267.
Ji, L., Deng, X., Geng, Y., Song, Z., & Zhang, Z. (2017). The additional benefit of ultrasonography to 2010 ACR/EULAR classification criteria when diagnosing rheumatoid arthritis in the absence of anti-cyclic citrullinated peptide antibodies. Clinical Rheumatology, 36(2), 261-267. https://doi.org/10.1007/s10067-016-3465-9
Ji L, et al. The Additional Benefit of Ultrasonography to 2010 ACR/EULAR Classification Criteria when Diagnosing Rheumatoid Arthritis in the Absence of Anti-cyclic Citrullinated Peptide Antibodies. Clin Rheumatol. 2017;36(2):261-267. PubMed PMID: 27848057.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The additional benefit of ultrasonography to 2010 ACR/EULAR classification criteria when diagnosing rheumatoid arthritis in the absence of anti-cyclic citrullinated peptide antibodies. AU - Ji,Lanlan, AU - Deng,Xuerong, AU - Geng,Yan, AU - Song,Zhibo, AU - Zhang,Zhuoli, Y1 - 2016/11/15/ PY - 2016/03/10/received PY - 2016/10/30/accepted PY - 2016/10/27/revised PY - 2016/11/17/pubmed PY - 2017/4/13/medline PY - 2016/11/17/entrez KW - Anti-CCP negative KW - Imaging–ultrasound KW - Rheumatoid arthritis (RA) SP - 261 EP - 267 JF - Clinical rheumatology JO - Clin Rheumatol VL - 36 IS - 2 N2 - The aim of this study was to assess the benefit of ultrasonography (US) contributing to 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria in diagnosing rheumatoid arthritis (RA), when anti-citrullinated protein (CCP) antibody and radiographic erosions are absent. Ninety-four patients suffering from arthritis of at least one joint in hands, symptom duration of less than 2 years, normal radiographs at baseline, and negative anti-CCP had 22 joint US assessments and were followed prospectively for at least 12 months. Sensitivity and specificity for final RA diagnosis based on 1987 RA criteria were determined for ultrasound variables. Logistic regression models were then fitted to evaluate predictive ability over and above the 2010 ACR/EULAR classification criteria. Twenty-nine of them were classified as RA patients and 65 had alternative diagnoses. There were significantly more joints with synovial hypertrophy, synovitis, and bone erosion detected by US in RA patients. The gray-scale (GS) variables positively correlated with acute phase reactants. The area under curve (AUC) values of GS and power Doppler (PD) were comparable, higher than bone erosion. However, regression analysis demonstrated that only PD involvement of joints, especially wrists, provided independently predictive data, with improved AUC values from 0.738 to 0.872 combined with 2010 ACR/EULAR classification criteria. PD scanning of hand joints, especially wrists, may provide independently assistance to 2010 ACR/EULAR criteria in the early diagnosis of RA in those patients who are negative for anti-CCP antibody. SN - 1434-9949 UR - https://www.unboundmedicine.com/medline/citation/27848057/The_additional_benefit_of_ultrasonography_to_2010_ACR/EULAR_classification_criteria_when_diagnosing_rheumatoid_arthritis_in_the_absence_of_anti_cyclic_citrullinated_peptide_antibodies_ L2 - https://dx.doi.org/10.1007/s10067-016-3465-9 DB - PRIME DP - Unbound Medicine ER -