![Sample our Medicine, Dentistry, Nursing & Allied Health journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5944/TOC-Subject-Sample-2021-Medicine-Dentistry-Nursing-Allied-Health.jpg"})
Abstract
Objectives: To clarify the use of musculoskeletal ultrasonography (US) of ankle joints in rheumatoid arthritis (RA).
Methods: Consecutive RA patients with or without ankle symptoms participated in the study. The US, clinical examination (CE), and patients’ visual analog scale for pain (pVAS) for ankles were assessed. Prevalence of tibiotalar joint synovitis and tenosynovitis were assessed by grayscale (GS) and power Doppler (PD) US using a semi-quantitative grading (0–3). The positive US and CE findings were defined as GS score ≥2 and/or PD score ≥1, and joint swelling and/or tenderness, respectively. Multivariate analysis with the generalized linear mixed model was performed by assigning ankle pVAS as a dependent variable.
Results: Among a total of 120 ankles from 60 RA patients, positive ankle US findings were found in 21 (35.0%) patients. The concordance rate of CE and US was moderate (kappa 0.57). Of the 88 CE negative ankles, US detected positive findings in 9 (10.2%) joints. Multivariate analysis revealed that ankle US, clinical disease activity index, and foot Health Assessment Questionnaire, but not CE, was independently associated with ankle pVAS.
Conclusion: US examination is useful to illustrate RA ankle involvement, especially for patients who complain ankle pain but lack CE findings.
Acknowledgments
We wish to thank Mr Tom Kiper for his critical review in preparing the manuscript.
Conflict of interest
Dr. Kirino is supported by grants from Japan Society for the Promotion of Science Grant-in-Aid for Scientific Research (Grant No. 26713036 and 15K15374), the Kanae Foundation for the Promotion of Medical Science, Takeda Science Foundation, and Yokohama Foundation for Advancement of Medical Science. Dr. Yoshimi is supported by grants from Japan Society for the Promotion of Science Grant-in-Aid for Scientific Research (Grant No. 26461468) and Yokohama Foundation for Advancement of Medical Science. The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.
Supplementary material available online.