並列タイトル等早期関節リウマチ患者において関節エコーで検出される前足部滑膜炎は、手部滑膜炎とは異なり、28関節評価での疾患活動性スコアと正の相関を示さない
タイトル（掲載誌）Journal of Nara Medical Association
一般注記type:Thesis
Objective : This study aimed to clarify the relationship between the ultrasound (US)-detected forefoot synovitis and systemic disease activity and functional disability in patients with early rheumatoid arthritis (ERA). Methods : Thirty-eight ERA patients (6 men, 32 women) prior to initiation of tight-control treatment were included. Semiquantitative US assessment for bilateral finger, wrist, and forefoot joints was conducted using gray-scale (GS) and power Doppler (PD), and each summation was defined as hand, foot, and total scores. The accuracy of US based on the physical examination for the metatarsophalangeal (MTP) joints was determined. The relationshio between each US score and composite measures using 28-joint counts, serum biomarkers, and patient-reported functional impairment scores was analyzed. Results : Based on MTP joint swelling and tenderness, for GS and PD scores ≥ 1, the positive predictive value was low (GS: 16.0%, 12.5%; PD: 38.5%, 17.5%). Hand US scores, especially in hand PD scores, showed a significant moderate positive correlation with disease activity scores and biomarkers; however, foot US scores showed no positive correlation with any factor. The results were robust in multivariate analyses that incorporated each score and were adjusted for age. Conclusions : US-detected forefoot synovitis may not be reflected in the composite disease activity scores not including direct forefoot assessment in ERA patients.
博士（医学）・乙第1521号・令和4年3月15日
identifier:Journal of Nara Medical Association Vol.72 No.4,5,6 p.51-59 (2021.11)
identifier:13450069
identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/4026
identifier:Journal of Nara Medical Association, 72(4,5,6): 51-59
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