Abstract

BETANCUR, Juan Felipe; MARTINEZ, Juan Pablo; TOBON, Gabriel Jaime  and  OCHOA, Carlos Darío. The role of ultrasound in the subclinical assessment of rheumatoid arthritis in remission. Systematic review of the literature. Rev.Colomb.Reumatol. [online]. 2015, vol.22, n.1, pp.31-46. ISSN 0121-8123.  https://doi.org/10.10167j.rcreu.2015.02.002.

There is an interest in the role of ultrasound (US), particularly the presence of power Doppler (PD) signal and synovial hypertrophy in the evaluation of subclinical activity in rheumatoid arthritis patients (RA) on remission. Objective: Examine the evidence to determine the usefulness of US and PD in the evaluation of patients with RA in remission using clinimetric properties. Materials and methods: A systematic literature search was performed using electronic data-bases PubMed, EMBASE, BioMed Central, Cochrane registry of clinical trials and secondary reference sources of articles published up to 2 March 2014, with the key terms "arthritis, rheumatoid" or "arthritis" and "ultrasonography" or "ultrasonography, Doppler, pulsed" and "remission induction" were used until March 2, of the 2014, without language restriction. Observational cohort studies that assessed the prevalence of subclinical activity by US and PD in adult patients with RA in clinical remission were included. Methodological quality of the articles was verified and relevant information extracted from each one. Results: A total of 13 studies were identified for analysis. RA activity using these imaging techniques was observed in 14.6 to 95% for US synovial hypertrophy and 1.2 to 64.5% for PD in remission patients using clinimetry. Conclusions: In RA patients with clinical remission, variable subclinical activity was observed with ultrasound detected by synovial hypertrophy and a positive intra-articular PD signal. The latter enables residual from inflammatory pannus to be differentiated, and to also predict relapse and correlate with disease progression, allowing therapeutic changes. More studies evaluating treatment and prognostic outcomes are required

Keywords : Rheumatoid arthritis; Ultrasound; Synovial hypertrophy; Power Doppler; Remission.

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