Musculoskeletal ultrasound as a screening-tool for rheumatoid arthritis: results of the “Rheuma-Truck” screening and awareness initiative

Advances in Rheumatology

Benedikt Ostendorf¹  Oliver Sander¹  Jutta G. Richter¹  Matthias Schneider¹  Ralph Brinks¹  Stefan Vordenbäumen¹  Philipp Sewerin¹  Alexander Lautwein¹  Aiko Liedmann¹  Hasan Acar¹  Mario Giulini¹  Marina Backhaus²  Sarah Ohrndorf³ 

[1] Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf Medical Faculty, Moorenstrasse 5, 40225, Duesseldorf, Germany;Department of Internal Medicine, Rheumatology and Clinical Immunology, Academic Hospital of the Charité Berlin, Park-Klinik Weissensee Berlin, Berlin, Germany;Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany;

关键词: Musculoskeletal ultrasound;    Screening;    Rheumatoid arthritis;    Osteoarthritis;   

DOI  :  10.1186/s42358-021-00233-0

来源: Springer

【 摘 要 】

ObjectiveTo evaluate musculoskeletal ultrasound (MSUS) as a screening tool for rheumatoid arthritis (RA) and osteoarthritis (OA) patients in a rheumatology-screening program.Patients and methodsTo raise awareness for rheumatic diseases, a mobile rheumatology office was deployed in different cities of Germany (“Rheuma-Truck”). Standardized questionnaire assessment, testing for rheumatoid factor and citrullinated peptide antibodies and medical student driven MSUS of the clinically dominant hand/foot including wrist, MCP-II, -III, -V, PIP-II, -III, MTP-II and -V were offered free of charge to the population. In case of suspicious results, a rheumatologist was consulted.ResultsIn MSUS, 192 of 560 selected volunteers (aged 18–89, mean 52.7 years; 72.9% female) had suspicious findings including synovitis or erosions primarily affecting the MTP-II (11.8%), dorsal wrist (8.9%), and MCP-II (7%). 354 of the 560 volunteers further visited a rheumatologist of whom 76 were diagnosed with RA. According to the ‘US7 Score’, a sum scores ≥ 5 was significantly predictive for RA (odds ratio (OR) 5.06; confidence interval (CI) 0.83–35.32). 313 volunteers displayed signs of OA including osteophytes, while MCP-II (36.2%), MCP-III (14.8%), and the wrist (10.5%) were mostly affected. Diagnosis of RA was favoured over OA if the wrist (OR 4.2; CI 1.28–13.95), MTP-II (OR 1.62; CI 1.0–2.6), and MCP-V (OR 2.0; CI 1.0–3.8) were involved.ConclusionMedical student driven MSUS by the ‘US7 Score’ can facilitate diagnosis of RA in rheumatology-screening programs due to the level of the score and the affected joints. A high rate of unknown OA signs was detected by MSUS. A mobile rheumatology office displays an opportunity to screen patients for RA and OA.

【 授权许可】

CC BY