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. 2022 Feb;81(2):232-236.
doi: 10.1136/annrheumdis-2021-219931. Epub 2021 Aug 18.

Very low prevalence of ultrasound-detected tenosynovial abnormalities in healthy subjects throughout the age range: OMERACT ultrasound minimal disease study

Jeanette Trickey #  1   2 , Ilfita Sahbudin #  1   2 , Mads Ammitzbøll-Danielsen  3 , Irene Azzolin  4 , Carina Borst  5 , Alessandra Bortoluzzi  6 , George Aw Bruyn  7   8 , Philippe Carron  9   10 , Coziana Ciurtin  11 , Georgios Filippou  12 , Jacek Fliciński  13 , Daniela Fodor  14 , Hélène Gouze  15 , Marwin Gutierrez  16   17 , Hilde Berner Hammer  18   19 , Ellen-Margrethe Hauge  20   21 , Annamaria Iagnocco  22 , Kei Ikeda  23 , Rositsa Karalilova  24 , Helen Isobel Keen  25 , Marion Kortekaas  26   27 , Giuliana La Paglia  28 , Gustavo Leon  29   30 , Peter Mandl  31 , Mihaela Maruseac  32 , Marcin Milchert  13 , Mohamed Atia Mortada  33 , Esperanza Naredo  34 , Sarah Ohrndorf  35 , Carlos Pineda  36 , Mads Nyhuus Bendix Rasch  20 , Cristina Reátegui-Sokolova  36   37 , Garifallia Sakellariou  38 , Teodora Serban  39 , Cesar A Sifuentes-Cantú  40   41 , Maria S Stoenoiu  42 , Takeshi Suzuki  43 , Lene Terslev  3 , Ilaria Tinazzi  44 , Florentin Ananu Vreju  45 , Ruth Wittoek  10   46 , Maria-Antonietta D'Agostino #  47 , Andrew Filer #  48   2
Affiliations

Very low prevalence of ultrasound-detected tenosynovial abnormalities in healthy subjects throughout the age range: OMERACT ultrasound minimal disease study

Jeanette Trickey et al. Ann Rheum Dis. 2022 Feb.

Abstract

Objectives: This study aimed to determine the prevalence of ultrasound-detected tendon abnormalities in healthy subjects (HS) across the age range.

Methods: Adult HS (age 18-80 years) were recruited in 23 international Outcome Measures in Rheumatology ultrasound centres and were clinically assessed to exclude inflammatory diseases or overt osteoarthritis before undergoing a bilateral ultrasound examination of digit flexors (DFs) 1-5 and extensor carpi ulnaris (ECU) tendons to detect the presence of tenosynovial hypertrophy (TSH), tenosynovial power Doppler (TPD) and tenosynovial effusion (TEF), usually considered ultrasound signs of inflammatory diseases. A comparison cohort of patients with rheumatoid arthritis (RA) was taken from the Birmingham Early Arthritis early arthritis inception cohort.

Results: 939 HS and 144 patients with RA were included. The majority of HS (85%) had grade 0 for TSH, TPD and TEF in all DF and ECU tendons examined. There was a statistically significant difference in the proportion of TSH and TPD involvement between HS and subjects with RA (HS vs RA p<0.001). In HS, there was no difference in the presence of ultrasound abnormalities between age groups.

Conclusions: Ultrasound-detected TSH and TPD abnormalities are rare in HS and can be regarded as markers of active inflammatory disease, especially in newly presenting RA.

Keywords: rheumatoid arthritis; tendinopathy; ultrasonography.

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Conflict of interest statement

Competing interests: There are no declared competing interests from authors except the following: CC declared grants from NIHR Versus Arthritis, Lilly sponsored EULAR conference travel, Modern Biosciences payment as DSM committee member, Roche consultancy fee and Novartis sponsored writing of one medical paper. KI declared a Mitsubishi-Tanabe research grant for RA; Abbvie, Eli Lilly, Mitsubishi-Tanabe, Bristol-Myers-Squib and Novartis speaker’s fees; and participation on a DSM board for Abbvie, Eli Lilly and Mitsubishi-Tanabe. RK declared support from Abbvie, Roche, Novartis and UCB with payments for travel to meetings/lectures, presentations, speakers’ bureaus, manuscript writing/educational events.

Figures

Figure 1
Figure 1
Percentage of tendons with grade 1–3 TSH and TPD, and presence of TEF in DF tendons 1–5 and ECU for HS according to age groups, compared with patients with RA. TEF measured only in HS. HS Y, 18–39 years; HS M, 40–59 years; HS O, 60–80 years. DF, digit flexor; ECU, extensor carpi ulnaris tendon; HS, healthy subjects; M, middle; O, old; RA, rheumatoid arthritis; TEF, tenosynovial effusion; TPD, tenosynovial power Doppler; TSH, tenosynovial hypertrophy; Y, young.
See this image and copyright information in PMC

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