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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
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Arthritis Research & Therapy

ISSN: 1478-6362

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