Hand and wrist arthralgia in systemic lupus erythematosus is associated to ultrasonographic abnormalities

Joint Bone Spine. 2013 Jul;80(4):402-6. doi: 10.1016/j.jbspin.2012.09.016. Epub 2012 Nov 10.

Abstract

Objective: Systemic lupus erythematosus (SLE) is an autoimmune disease which may has joint impairment. Often, SLE patients complain of hand and wrist arthralgia (HA). Usually, these patients do not show any swelling in the physical exam. Our aim was to demonstrate Power Doppler Ultrasound (PDUS) abnormalities in SLE patients with HA.

Methods: We recruited 58 consecutive SLE patients and divided them into two groups: case group (n = 28) were patients with HA, and control group (n = 30) were patients without HA. We also collected socio-demographic and disease activity data, biological markers and SLEDAI index. We evaluated disability and quality of life by mHAQ and SF-12, respectively. We performed a bilateral hand and wrist PDUS on all patients. PDUS findings were based in OMERACT-7 group criteria.

Results: We found PDUS abnormalities in most of SLE patients who suffered HA, when compared to SLE controls (P < 0.001). The main findings in Case Group were: tenosynovitis (39.2%), synovial effusion or hypertrophy (25%) and active synovitis (14.2%). SLEDAI score and dsDNA antibodies were related to the presence of PDUS abnormalities (P < 0.05 and P < 0.001, respectively). We also found worse physical SF-12 (P < 0.05) and mHAQ (NS) scores in case group.

Conclusions: SLE patients who present HA have more PDUS abnormalities. These findings are associated with a higher SLEDAI score and dsDNA antibodies. This articular affection may contribute to a worsened functional ability and a lower quality of life. PDUS seems to be a reliable tool in the assessment of SLE patients with HA.

Keywords: Disability; Hand; Joint; Quality of life; Systemic lupus erythematosus; Ultrasound.

MeSH terms

  • Adult
  • Arthralgia / diagnostic imaging*
  • Arthralgia / epidemiology*
  • Arthralgia / pathology
  • Case-Control Studies
  • Comorbidity
  • Cross-Sectional Studies
  • Disability Evaluation
  • Female
  • Hand Joints / diagnostic imaging*
  • Hand Joints / pathology
  • Humans
  • Lupus Erythematosus, Systemic / diagnostic imaging*
  • Lupus Erythematosus, Systemic / epidemiology*
  • Lupus Erythematosus, Systemic / pathology
  • Middle Aged
  • Quality of Life
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Ultrasonography, Doppler
  • Wrist Joint / diagnostic imaging*
  • Wrist Joint / pathology