Rheumatoid Arthritis Clinical Trial
Official title:
Correlation of "Painless" Synovitis With Clinical, Laboratory and Radiological (X-ray, Sonography) Finds in Patients With Longstanding Rheumatoid Arthritis (RA).
There is a group of patients with rheumatoid arthritis (RA) that suffer from chronically
painless synovitis in the hands.
The objective of this study is to compare painless synovitis with painful synovitis
according to the sonographic (Gray-scale and power Doppler) findings.
A sonographic examination (Gray-scale and power Doppler) will be done to evaluate
metacarpophalangeal joints of patients without local painful and will be a comparison with
patients with local painful.
Introduction/Objectives:
There is a group of patients with rheumatoid arthritis (RA) that suffer from chronically
painless synovitis in the hands. The mean of this is still unknown and does not exist
studies in the literature that assessing the predictors of this behavior or synovial
potential to cause bone erosion.
The objective of this study is to compare painless synovitis (called "cold" synovitis) with
painful synovitis according to the sonographic (Gray-scale and power Doppler) findings,
articular damage (x-Ray and sonography), clinical, laboratory and demographic variables in
RA patients.
Methods: Cross-sectional study with RA patients, which will be evaluated metacarpophalangeal
joints of patients without local painful. Sixty RA patients will be selected in the Federal
University of São Paulo ambulatory (Unifesp). The patients will be divided in two groups of
thirty patients each: "painless synovitis" Group and "painful synovitis" Group. All patients
will be measured through clinical evaluation, hands ultrasound and laboratory parameters
(erythrocyte sedimentation rate, ESR; rheumatoid factor, RF; anti-cyclic-citrullinated
peptide antibodies, CCP) on the same day. The clinical evaluation will be measured by a
trained rheumatologist with experience in joint physical examination (synovitis). This
measure will be done before the sonography examination and the assessment tools will be:
painful joint count; swollen joint count; painful visual analogue scale (VAS 0-10); swollen
VAS; activity disease VAS; measurement of grip strength and pinch with Jamar dynamometer and
Preston Pinch Gauge; 28 joint Disease Activity Score (DAS 28); Stanford Health Assessment
Questionnaire (HAQ); Cochin Hand Functional Scale (CHFS) and patient clinical evaluation.
The level of statistical significance will be 5%.
;
Time Perspective: Retrospective
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