Estimation of Disease Activity in Rheumatoid Arthritis: A Correlation Study between Clinical, Inflammatory Markers and Power Doppler Ultrasonography

Objective: To correlate between clinical, inflammatory markers and power Doppler (PD) ultrasonography (USG) to assess the disease activity in rheumatoid arthritis (RA) patients. Methods: Sixty consecutive patients with RA were included. Demographic and clinical data, C-reactive protein (CRP) level, and erythrocyte sedimentation rate (ESR) were recorded. All patients underwent an USG PD by an experienced ultrasonologist. USG joint effusion, synovitis, and PD signal were graded from 1 to 3 in a small joint of both hands (metacarpophalangeal, proximal interphalangeal, and wrist). Joint count and joint index for effusion, synovitis, and PD signal were recorded for a total of 22 joints. Result: Among 60 patients, 41 were female and 19 were male. The correlation coefficient between ESR with tender joint, swollen joint, USG synovitis, and USG hyperemia was 0.13, 0.13, 0.58, and 0.33, respectively. The correlation coefficient between CRP with tender joint, swollen joint, USG synovitis, and USG hyperemia was 0.46, 0.07, 0.36, and 0.27, respectively. Conclusion: USG PD is an important tool along with clinical assessment and inflammatory marker to assess the disease activity in RA patients.