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Table 1 Overview of selected studies

From: What is the value of musculoskeletal ultrasound in patients presenting with arthralgia to predict inflammatory arthritis development? A systematic literature review

Study Study population N Female (%) Age (years; mean (±SD) or median (IQR)) Symptom duration at inclusion (mean (±SD) or median (IQR)) Outcome of relevance Mean follow-up duration (months; mean (±SD) or median (IQR)) N (%) patients with outcome Duration until diagnosis/ outcome (months) Univariable Adjustment factors Multivariable
Rakieh et al. 2015 [11] ACPA+ patients with MSK symptoms
(primary and secondary care)
100 69 51.2 ± 11.9 22.7 (8.2–42.4) months IA 19.8 (7.6–34.4) 50 (50.0) 7.9 (3.2–14.5) PDUS≥ 1: HR 1.88 (1.07–3.29) Tenderness small joints
Morning stiffness ≥ 30 min
High ++ RF and/or ACPA
PDUS ≥ 1: HR 1.51 (0.83–2.74) ¥
Nam et al. 2016 [10] ACPA+ patients with MSK symptoms
(primary and secondary care)
136 73.7 51.3 ± 12.4 17.2 (7.0–33.4) months IA 28.1 (range 4.7–79.6) for non-progressors 57 (41.9) 18.3 (range 0.1–79.6) GSUS ≥ 2: HR 2.8 (0.4–20.3)
PDUS ≥ 1: HR 1.6 (0.9–3.2)
None ND
van der Ven et al. 2017 [8] Inflammatory arthralgia in > = 2 painful joints (hands, feet, shoulders), plus 2 additional criteria*
(secondary care)
174 83 45.0 ± 11.3 7.0 ± 3.1 months IA 12 31 (17.8) Within 1 year; not specified GSUS ≥ 2 and/or PDUS ≥ 1 :
OR 3.03 (1.69–5.41)
PDUS ≥ 1:
OR 3.12 (1.61–6.03)
GSUS ≥ 2 and/or PDUS ≥ 1 :
Age
Morning stiffness > 30 min
ACPA
PDUS ≥ 1:
Age
Morning stiffness > 30 min
GSUS ≥ 2 and/or PDUS ≥ 1 :
OR 2.65 (1.44–4.88)
PDUS ≥ 1:
OR 3.44 (1.71–6.95)
van de Stadt et al. 2010 [12] Arthralgia with RF+ and/or ACPA+
(secondary care)
192 72 47 ± 11 12 (9–36) months Arthritis 26 (range 6–54) 45 (23.4) 11 ± 9 Synovitis: OR 1.41 (0.54–3.65)
PDUS: OR 1.54 (0.67–3.54)
Effusion: OR 2.05 (0.80–5.27)
Tenosynovitis: OR 1.50 (0.44–5.11)
None ND
Pratt et al. 2013 [9] Inflammatory arthralgia
(secondary care)
379 72 51 (36–66) 20 (10–34) weeks Persistent IAǂ 27 (range 12–44) 162 (42.7) NP NP Age
Symptom duration
Swollen joint count
CRP
ACPA
ESR
Grade 1 GSUS synovitis in ≥ 3/16 joints: OR 4.91 (2.32–10.4)
Zufferey et al. 2017 [7] ACPA- and RF- inflammatory polyarthralgia > 6 weeks
(secondary care)
80 77 51 ± 14 NP RA 18 ± 7 7 (8.8) 18 NP Gender
Elevated CRP
SONAR > 8/22: OR 7.45 (1.19–42.8)
US score ≥ 2 joints with grade ≥ 2 synovitis: OR 10.1 (1.1–49)
  1. Studies marked in bold are scored as high-quality (high-quality study > 80% (which is the median of all quality scores))
  2. GSUS greyscale ultrasound, NA not applicable, ND not done, NP not presented, NPV negative predictive value, PPV positive predictive value, PDUS power Doppler ultrasound, IA inflammatory arthritis, MSK musculoskeletal
  3. *Morning stiffness for more than 1 h, unable to clench a fist in the morning, pain when shaking someone’s hand, pins and needles in the fingers, difficulty wearing rings or shoes, family history of RA and/or unexplained fatigue for < 1 year
  4. ǂPersistent IA was defined as RA, psoriatic arthritis, enteropathic arthritis, ankylosing spondylitis, undifferentiated spondyloarthritis, connective tissue disease, “self-limiting inflammatory/reactive arthritis” warranting DMARD treatment and other inflammatory arthritides
  5. ¥In the PDUS model corrected for tenderness small joints, morning stiffness ≥ 30 min, high ++ RF and/or ACPA
  6. § One or more swollen joint on physical examination
  7. See Table 2 for a detailed description of the cut-offs and thresholds used to define a positive US