Author (year) [ref] Phase* | Study population | Number; type of joints or tendons | US modality, definition of synovitis (A-F) | Outcome, Risk estimates (95% CI) | Authors' conclusions | Limitations# |
---|---|---|---|---|---|---|
Filer (2011) [16] 3 | 58 IA 22 RA | 38; MCP, PIP, MTP, wrists, elbows, shoulders, knees, ankles | GSUS & PDUS A | US reclassifies 3 of 29 IA patients to RA (ACR 2010) | US of MCP, wrists and MTP improves optimally clinical models to predict RA | Q4E |
Freeston (2010) [14] 3 | 30 patients with inflammatory symptoms and negative RF and aCCP tests | 12; MCP, wrists and flexor tendons of fingers | GSUS & PDUS B | US increases pretest probability for arthritis at one year from 6 to 94% | Inflammation at US predicts development of arthritis in patients with inflammatory symptoms and negative RF and aCCP tests | Q1D, Q2C |
Ozgul (2009) [17] 3 | 51 IA | 50; shoulders, elbows wrists, MCP, PIP, DIP, knees, ankles, MTP | GSUS C | Kappa = 0.61 for US diagnosis of RA versus clinical diagnosis | Average agreement between US and clinical examination when diagnosing RA | Q1A, Q1E, Q4E |
Salaffi (2010) [15] 3 | 149 UA | 18; wrists, MCP2-5, PIP2-5 | GSUS & PDUS D | Sensitivity 0.35 (0.24, 0.48) and specificity 0.78 (0.67, 0.86) for US as baseline test, predicting RA at 1 year | Presence of PDUS signs predicts progression from UA to RA | Q1A, Q1C, Q1E, Q3B, Q4E |
Stadt (2010) [18] 3 | 192 RF and/or aCCP-positive arthralgia patients, clinically without arthritis | Painful joint + adjacent and contralateral joints, mean 8 joints per patient | GSUS & PDUS E | JE: OR = 3.07 (1.05, 8.9); SH: OR = 5.5 (2.3, 12) PD: OR = 5.5 (2.6, 12), all for future arthritis | Inflammation at US predicts future arthritis in aCCP-positive patients clinically without arthritis | Q4E |
Wakefield (2004) [19] 3 | 80, Oligoarthritis | First 40 patients: only symptomatic joints Last 40 patients: 22; MTP, MCP, Knees | GSUS F | 1/3 of cases of oligoarthritis reclassified to polyarticular (>= 6 joints) arthritis | GSUS detects inflammation in more joints than clinical exam, but 8% of joints with clinical synovitis are normal at US | Q2C |