Ultrasound of the hand: can this detect rheumatoid arthritis during remission?

This study investigated if ultrasound of the hand can accurately detect inflammation in patients with rheumatoid arthritis in remission.

They found that ultrasound detected inflammation in a high number of patients in clinical remission of rheumatoid arthritis.

Ultrasound (US) is used to determine if a patient with rheumatoid arthritis (RA) has inflammation or swelling in a joint. The severity of RA is rated using a Disease Activity Score measuring 28 joints (DAS28). Patients are said to be in clinical remission (non-active disease, mild to absent symptoms) when DAS28 is less than 2.6.

Some patients may be in clinical remission from RA and still have inflammation in certain joints. It is important to monitor this to determine if the condition may worsen. US may be useful for this purpose, however using US on all joints is time-consuming. 

This study assessed using ultrasound to identify subclinical (no symptoms) inflammation in the hands of patients in remission from RA.

209 patients with RA were included in this study. Patients were assessed at the beginning of the study and 6 months and 12 months later. They were assessed using several disease activity measures including DAS28 and measurement of protein levels involved in inflammation.

US examination identified inflammation in joints of the hands of over 90% of patients in clinical remission at both 6 and 12 months.

This study concluded that ultrasound detected inflammation in a high number of patients in clinical remission of rheumatoid arthritis.

The majority of participants in this study were female (81%). The results may not extend to the wider male population. Patients also had established RA and taking specific disease-modifying drugs (biological DMARDs). The results may not be applicable to recent onset RA or patients taking synthetic DMARDs.

If you have any concerns regarding treatment or monitoring of rheumatoid arthritis, please consult with your physician.