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Joint Bone Spine. 2018 Dec;85(6):741-745. doi: 10.1016/j.jbspin.2018.01.013. Epub 2018 Feb 15.

Ultrasonography and detection of subclinical joints and tendons involvements in Systemic Lupus erythematosus (SLE) patients: A cross-sectional multicenter study.

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Rheumatology Unit, centre hospitalier regional d'Orleans, 14, avenue de l'Hôpital, CS 86709, 45067 Orleans cedex 2, France. Electronic address:
Rheumatology, centre hospitalier du Mans, 72037 Le Mans, France.
Rheumatology, hôpital Sud, 35033 Rennes, France.
Rheumatology, CHRU de Tours, 37000 Tours, France.
Internal medicine, GFEV, 44093 Nantes, France.
Rheumatology, CHU Hôtel-Dieu, 44093 Nantes, France.
Rheumatology, CHU la-Cavale-Blanche, 29200 Brest, France.
Rheumatology, CHU Pellegrin, 33000 Bordeaux, France.
Internal medicine, CHU de Bordeaux, 33000 Bordeaux , France.
Rheumatology Unit, centre hospitalier regional d'Orleans, 14, avenue de l'Hôpital, CS 86709, 45067 Orleans cedex 2, France.
DIM, Centre hospitalier regional d'Orleans, 45067 Orleans cedex 2, France.



The aims of this study in SLE population were (1) to describe ultrasonography (US) joint abnormalities, (2) to estimate the reliability of clinical swollen joint count (C-SJC) and SLEDAI (C-SLEDAI) versus US-SJC and US-SLEDAI scores, (3) to highlight specific patterns of lupus patients with Power Doppler (PD) abnormalities.


For this cross-sectional multicenter study, 151 consecutive adult SLE patients were recruited. Evaluation included a clinical standardized joint assessment, B-mode and PD US of 40 joints and 26 tendons blinded for clinical examination. Reliability and agreement between clinical and B-mode US were calculated using the intraclass correlation coefficients (ICC [95% Confidence Interval]).


We found a very high frequency of subclinical US abnormalities in asymptomatic patients: 85% of patients without joint symptoms had at least 1 US abnormality. Among them 46 patients (87%) had a history of joint involvement. The most frequent abnormalities were joint effusmaions (108 patients), synovial hypertrophy (SH, 109 patients) and synovitis (61 patients). Joint or tendon PD signal (grade>1) was found in 44% of patients (67/151). Synovitis were mainly located especially on MCPs and wrists. Even if reliability between clinical and grey-scale US SJC assessments was poor, reliability between clinical and US SLEDAI was good. Comparison between SLE patients with and without PD signal did not show any specific SLE pattern.


US may be useful to assess joint involvement in SLE patients but did not significantly change SLEDAI score.


Rhupus; Synovitis; Systemic Lupus Erythematosus; Ultrasonography

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