Drs. M. Backhaus and Ohrndorf contributed equally to this work.
Evaluation of a novel 7-joint ultrasound score in daily rheumatologic practice: A pilot project
Version of Record online: 27 AUG 2009
Copyright © 2009 by the American College of Rheumatology
Arthritis Care & Research
Volume 61, Issue 9, pages 1194–1201, 15 September 2009
How to Cite
Backhaus, M., Ohrndorf, S., Kellner, H., Strunk, J., Backhaus, T. M., Hartung, W., Sattler, H., Albrecht, K., Kaufmann, J., Becker, K., Sörensen, H., Meier, L., Burmester, G. R. and Schmidt, W. A. (2009), Evaluation of a novel 7-joint ultrasound score in daily rheumatologic practice: A pilot project. Arthritis & Rheumatism, 61: 1194–1201. doi: 10.1002/art.24646
- Issue online: 27 AUG 2009
- Version of Record online: 27 AUG 2009
- Manuscript Accepted: 20 MAY 2009
- Manuscript Received: 22 NOV 2008
- Abbott GmbH & Co. KG, Max-Planck-Ring 2a, 65205 Wiesbaden, Germany
To introduce a new standardized ultrasound score based on 7 joints of the clinically dominant hand and foot (German US7 score) implemented in daily rheumatologic practice.
The ultrasound score included the following joints of the clinically dominant hand and foot: wrist, second and third metacarpophalangeal and proximal interphalangeal, and second and fifth metatarsophalangeal joints. Synovitis and synovial/tenosynovial vascularity were scored semiquantitatively (grade 0–3) by gray-scale (GS) and power Doppler (PD) ultrasound. Tenosynovitis and erosions were scored for presence. The scoring range was 0–27 for GS synovitis, 0–39 for PD synovitis, 0–7 for GS tenosynovitis, 0–21 for PD tenosynovitis, and 0–14 for erosions. Patients with arthritis were examined at baseline and after the start or change of disease-modifying antirheumatic drug (DMARD) and/or tumor necrosis factor α (TNFα) inhibitor therapy 3 and 6 months later. C-reactive protein level, erythrocyte sedimentation rate, rheumatoid factor, anti–cyclic citrullinated peptide, Disease Activity Score in 28 joints (DAS28), and radiographs of the hands and feet were performed.
One hundred twenty patients (76% women) with rheumatoid arthritis (91%) and psoriatic arthritis (9%) were enrolled. In 52 cases (43%), erosions were seen in radiography at baseline. Patients received DMARDs (41%), DMARDs plus TNFα inhibitors (41%), or TNFα inhibitor monotherapy (18%). At baseline, the mean DAS28 was 5.0 and the synovitis scores were 8.1 in GS ultrasound and 3.3 in PD ultrasound. After 6 months of therapy, the DAS28 significantly decreased to 3.6 (Δ = 1.4), and the GS and PD ultrasound scores significantly decreased to 5.5 (−32%) and 2.0 (−39%), respectively.
The German US7 score is a viable tool for examining patients with arthritis in daily rheumatologic practice because it significantly reflects therapeutic response.