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Articular sonography: findings in normal subjets compared with Rheumatoid Arthritis pacients

Grant number: 09/54559-3
Support Opportunities:Regular Research Grants
Start date: February 01, 2010
End date: January 31, 2012
Field of knowledge:Health Sciences - Medicine - Medical Clinics
Principal Investigator:Jamil Natour
Grantee:Jamil Natour
Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil

Abstract

Rheumatoid arthritis (RA) is a chronic inflammatory, systemic and auto-imune disorder affecting primarily the joints. In RA, inflammatory synovium causes destruction of cartilage, erosion of the adjacent bone and ultimately loss of function of the affected joint. Newer imaging techniques, such as ultrasound (US), have shown promise in evaluation of RA. Many US scoring system had been used to classify and quantify the synovium, effusion, erosion and cartilage for assessing and monitoring AR. However, its use is considered problematical because there are very few data on normal joints and, at this point, there is no clear definition of excess amount of synovium in normal people. Primary objectives: establish the normality of sonographic synovial measures in joints more affected in RA patients and establish, in those joints, a sonographic value of synovium predictive of RA. Material and methods: a transversal study will be carried out on patients diagnosed with RA and in normal subjects. The following assessment instruments will be used: /. Clinical Instruments: Visual Analogue Scale 0-10 cm for joint pain at rest and during movement and for joint edema; goniometry; functional questionnaire (HAQ), matinal rigidity in minutes; 28-joint Disease Activity Score. 2. Ultrasonographic Instruments (quantitative and semi-quantitative measures): synovial hyperplasia, synovial blood flow (Power Doppler), bone erosions and cartilage. The joints that will be evaluated: hands, wrists, elbows, shoulders, hips, knees and feet. Ultrasonographic interobserver reprodutibility will be carried out in 10% of the patients. All the examinators will be blind for each other findings. Rheumatoid factor and anti-CCP will be investigated in RA patients. Statistical significance will be set at 5%. (AU)

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
MACHADO, FLAVIA SOARES; NATOUR, JAMIL; TAKAHASHI, ROGERIO DINIZ; FURTADO, RITA N. V.. ARTICULAR ULTRASOUND IN ASYMPTOMATIC VOLUNTEERS: IDENTIFICATION OF THE WORST MEASURES OF SYNOVIAL HYPERTROPHY, SYNOVIAL BLOOD FLOW AND JOINT DAMAGE AMONG SMALL-, MEDIUM- AND LARGE-SIZED JOINTS. ULTRASOUND IN MEDICINE AND BIOLOGY, v. 43, n. 6, p. 1141-1152, . (09/54559-3)
MACHADO, FLAVIA S.; NATOUR, JAMIL; TAKAHASHI, ROGERIO D.; DE BUOSI, ANA LETICIA P.; FURTADO, RITA N. V.. Sonographic Assessment of Healthy Peripheral Joints Evaluation According to Demographic Parameters. JOURNAL OF ULTRASOUND IN MEDICINE, v. 33, n. 12, p. 2087-2098, . (09/54559-3)
MACHADO, FLAVIA SOARES; VILAR FURTADO, RITA NELY; TAKAHASHI, ROGERIO DINIZ; PIROSI DE BUOSI, ANA LETICIA; NATOUR, JAMIL. SONOGRAPHIC CUTOFF VALUES FOR DETECTION OF ABNORMALITIES IN SMALL, MEDIUM AND LARGE JOINTS: A COMPARATIVE STUDY BETWEEN PATIENTS WITH RHEUMATOID ARTHRITIS AND HEALTHY VOLUNTEERS. ULTRASOUND IN MEDICINE AND BIOLOGY, v. 41, n. 4, p. 989-998, . (09/54559-3)