Imaging methods in assessing the course of ra

Objectives Rheumatoid arthritis (RA) is the most prevalent chronic inflammatory joint disease, and it is responsible for structural damage.Ultrasound (US) changes in early RA are considered as one of the ways of predicting disease outcomes too. Materials 61 RA pts, mean age 50,0 [38,0; 59,0] yrs, mean disease duration 7 [4; 20] months were treated with MTX and biologics according to Treat-To-Target concept. Among them 40 patients with early RA, mean age 51,0 [43,0; 60,0], disease duration 5 [3; 6,5] months.The wrist, MCP2 and MCP3, PIP2 and PIP3 joints, as well as MTP2 and MTP5 joints of the clinically dominant side were examined by ultrasound (US).Hands and feet US with gray scale (GS), power Doppler (PD) and destructive changes (erosion), according to the criteria of OMERACT, were analyzed before initiation of treatment and in 3, 6, 9 and 12 months after. A binary scoring system (presence/absence of erosions) of the joints examined was used. Radiographs were obtained at baseline, at 12 months, 4 years and 7 years, radiographic changes were assessed using Sharp/van der Heijde modified scoring method. Radiographic progression was documented based on Sharp/Van der Heijde modified score changes during the follow up. Results RA progression by 4 years FUP was identified in 36% (22 p) of pts, by 7 years FUP was identified in 69% (42 p) of pts.During the 7 years FUP 42 of 61 patients had radiographic progression: the count of erosion increased from 0 [0; 3] to 3 [1; 11]. At the same time, on the background of therapy during the first year, a decrease in ultrasound signs of inflammation was determined according to the GS and PD: from 6 [4; 9] to 4 [2; 6] p = 0.000 and from 2 [1; 6] to 0 [0; 2] p = 0.000, respectively, and increase in the number of joints with erosions (from 1 [0; 2] to 2 [0; 3], p = 0.000).All pts divided into groups based increase in erosions according to radiography (Rg +) and without it (Rg-). GS at baseline was significantly higher in the group Rg + than in Rg- group (6 [5; 10] and 5 [1; 8], respectively, p=0.04). CRP at 3 months and at 6 months was significantly higher in RG+ group than in RG- group (4,15 [1,2; 8,7] and 1,2 [0; 3,5], respectively, p=0.03 and 2,35 [0,8; 10,1] and 0,4 [0; 4,3], respectively, p=0.025). Conclusions Thus, we obtained the first data on the important prognostic role of ultrasound in assessing the progression of early RA in a prospective seven-year follow-up.