Morbidity and mortality in rheumatoid patients during treatment with adalimumab and infliximab

The role of ultrasonography in early detection and monitoring of shoulder erosions, and disease activity in rheumatoid arthritis patients; comparison with MRI examination

OBJECTIVES

To determine the accuracy of ultrasound in early detection of bone erosions and monitoring disease activity in rheumatoid arthritis (RA) patients using magnetic resonance imaging (MRI) as a gold standard technique.

MATERIAL AND METHODS

This prospective study was carried out on 50 patients with known RA and 15 healthy controls. Conventional radiography was standardized and performed in two planes. Ultrasound (US) and MRI was performed to evaluate the presence of synovitis, tenosynovitis, and bursitis as well as erosions on ultrasound and MRI. The results in the study group were compared with those obtained in a control group.

RESULT

In the study group, the most frequent US finding of shoulder joint was Tenosynovitis of the long head of the biceps tendon. Tenosynovitis was observed in the long head of biceps tendon in 20 joints (40%). Erosions of the humeroscapular joint were detected by conventional radiography in 15 (30%), by US in 41 (82%), and by MRI in 46 (92%) of the shoulders examined, no statistically significant difference is noted between US and MRI in overall detection of erosion (P = .333).

CONCLUSION

US is a helpful imaging method and in comparison with MRI in assessing the shoulder joint and, preferably with MRI, are recommended as additional techniques in the initial diagnostic evaluation when radiography yields negative results.

InforMatrix: treatment of rheumatoid arthritis using biologicals

This article offers an interactive decision matrix technique (InforMatrix), in which a group of experts in rheumatology determine an order of merit within the various biologicals used for rheumatoid arthritis. In this order of merit, six criteria (efficacy, safety, tolerance, ease of use, applicability and costs) are weighed against each other. Data necessary for this weighing process are derived from both literature, as well as clinical practice experience. This article provides an overview of the most relevant clinical trials on the biologicals, as well as a description of the interactive decision matrix technique. Using this interactive matrix technique makes rational consideration of the treatment options for rheumatoid arthritis possible.