Joint Ultrasound Evaluation of Asymptomatic Rheumatic Feet
Joint Ultrasound Evaluation of Asymptomatic Feet in Patients With Rheumatoid Arthritis: A Controlled Study
Objectives: The aims of the present study were to compare ultrasound on asymptomatic feet of patients with rheumatoid arthritis (RA) and normal controls, determine the association between ultrasound and global disease activity, function and goniometric measures in patients with RA and determine the correlation between ultrasound and radiography in the detection of bone erosion.
Methods: The foot joints (talocrural, talocalcaneal, talonavicular, naviculocuneiform, calcaneocuboid, 5th tarsometatarsal and 1st to 5th metatarsophalangeal [MTP] joints) of 50 healthy subjects and 50 patients with RA (all with asymptomatic feet) were evaluated bilaterally regarding quantitative/semi-quantitative synovitis, semi-quantitative Power Doppler (PD) signals and erosion using ultrasound. Statistical significance was set to 5%.
研究概览
地位
条件
研究类型
注册 (实际的)
联系人和位置
学习地点
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SP - Sao Paulo
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Sao Paulo、SP - Sao Paulo、巴西、04023-062
- Universidade Federal de Sao Paulo
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
取样方法
研究人群
描述
Inclusion Criteria:
Rheumatoid Arthritis Group:
- RA with at least one year since diagnosis
- Asymptomatic feet
- Age between 18 and 65 years Control group
- absence of known osteoarticular disease
Exclusion Criteria for both groups:
- Peripheral venous insufficiency with retrograde venous flow and/or ochre dermatitis
- Previous surgical intervention and/or fracture in feet/ankles
- Intra-articular corticosteroid injection in previous three months in any of the joints evaluated
- Foot neuropathy
- Pain and swelling in feet or ankles
学习计划
研究是如何设计的?
设计细节
队列和干预
团体/队列 |
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Rheumatoid Arthritis Group
RA with at least one year since diagnosis, asymptomatic feet, and age between 18 and 65 years
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Control group
Absence of known osteoarticular disease
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
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Presence of synovial effusion and/or synovial hypertrophy
大体时间:Baseline
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Ultrasound evaluation - quantitative measurement considered the distance between the joint capsule and subchondral bone of the joints studied (talocrural, talocalcaneal (medial, lateral and posterior windows); dorsal face of calcaneocuboid, talonavicular, medial naviculocuneiform, 5th tarsometatarsal and metatarsophalangeal (MTP) (dorsal and volar faces of 1st to 5th MTP joints and lateral face of 1st and 5th MTP joints).
A modified score was used for the semi-quantitative measurement, ranging from 0 to 3: 0-no synovial thickening; 1-minimal synovial thickening in joint recess; 2-synovial thickening in entire joint recess causing bulging of joint capsule; and 3-synovial thickening in joint recess with bulging of joint capsule and extending to at least one bone diaphysis.
"Presence of synovitis" was defined as synovial hypertrophy of at least Grade 1 in the semi-quantitative analysis (gray scale - ultrasound)
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Baseline
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Presence of bone erosion
大体时间:Baseline
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defined based on the preliminary OMERACT criteria: intra-articular discontinuity of the bone surface observed on two perpendicular planes.
A previously established semi-quantitative score (0-3) was employed: 0-uniform bone surface; 1-irregular bone surface; 2-bone surface defect on two planes; 3-bone defect causing extensive bone destruction.
The "presence of erosion" was defined as the presence of at least Grade 2 erosion.
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Baseline
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
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Radiographic evaluation
大体时间:Baseline
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A blinded radiologist analysed the presence of erosion in each joint studied.
For such, ankle (AP and profile) and foot (AP and profile with load) radiographs were taken.
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Baseline
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Intraobserver and interobserver agreement
大体时间:Baseline
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The patients with RA were submitted to clinical and ultrasound evaluations of the feet and ankles on the same day.
The ultrasound measurements intraobserver/interobserver agreement was performed on the talocrural, talonavicular and 5th MTP joints, using 20% of the sample.
For this, the ultrasound exams were performed by another rheumatologist.
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Baseline
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Presence of synovial blood flow
大体时间:Baseline
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The presence of Power Doppler (PD) signals was evaluated in the bone margins, joint spaces, and peri-articular tissues (frequency of 8 MHz and pulse repetition rate of 750 MHz).
A semi-quantitative score (0-3) was employed[14]: 0-no signal; 1-minimal signal, presence of simple vessels; 2-moderate signal, presence of confluent vessels with signal in less than 50% of the area evaluated; 3-intense signal (more than 50% of area evaluated).
"Active synovitis" or "presence of PD signal" was defined as the presence of intra-articular synovitis with a positive PD signal (at least Grade 1).
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Baseline
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合作者和调查者
调查人员
- 首席研究员:Rita Furtado, MD、Federal University of São Paulo
研究记录日期
研究主要日期
学习开始
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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