Session Information
Title: Fibromyalgia, Soft Tissue Disorders, Regional and Specific Clinical Pain Syndromes: Research Focus
Session Type: Abstract Submissions (ACR)
Background/Purpose: pain is the hallmark symptom of fibromyalgia (FM). The relationship with inflammation and/or structural changes in patients with fibromyalgia with pain localized in the hands is not clear. The aim of the present study was to describe the prevalence of different US abnormal findings at hand level in patients with FM.
Methods: consecutive patients with FM according to 1990 ACR criteria in whom a scan of the small joints of both hands due to the presence of pain was performed, were included. Patients with other definite inflammatory autoimmune rheumatic condition and/or with a secondary FM were excluded. US examinations were performed by the same experienced rheumatologist blinded to all clinical data using a My Lab 70 machine (Esaote) provided with a linear transducer of 6-18 MHz. US assessments included both grayscale and power Doppler (PD) US and were performed according to reference standard methods. The following US abnormal findings were evaluated bilaterally at joint level (wrist, metacarpophalangeal (MCP), proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints): joint cavity widening (JCW) due to the presence of joint effusion and/or synovial hypertrophy, PD signal due to the presence of an increased abnormal vascularization and degenerative changes (osteophytes). Tenosynovitis due to the presence of tendon sheath distension (TSD) and/or PD signal (increased abnormal vascularization) was assessed at tendon level (flexor finger tendons and extensor tendons compartments of the wrist).
Results: a total of 94 patients with FM and with an US examination of both hands were included. Ninety-one (96.8%) patients were female, mean age was 57.4 years (SD: 12.1) and mean disease duration was 2.7 years (SD: 1.8). JCW was detected in 6 (6.4%) patients at PIP joints, in 6 (6.4%) patients at MCP joints and in 8 (8.1%) patients at wrist level. Tenosynovitis due to the presence of TSD was found in 12 (12.7%) patients at extensor tendon compartments of the wrist and in 7 (7.4%) patients at finger flexor tendons. None of the patients with JCW at joint level and/or TSD at tendon level showed increased abnormal vascularization by PD signal.Thirty (32%) patients showed osteophytes at small joints and 19 (20.2%) patients had also degenerative changes at trapeziometacarpal level (rizarthrosis).
There were no significant statistical differences regarding ESR, CRP, rheumatoid factor and CCP levels between patients with and without US abnormal findings (p ≥ 0.05 for all comparisons).
Conclusion: a minority of patients with FM and hand pain showed US inflammatory abnormal findings on grayscale assessment and none of them showed abnormal vascularization by PD signal. The presence of degenerative changes (osteophytes) was the most frequent US abnormal finding.
Disclosure:
M. Bravo,
None;
J. Rosa,
None;
S. Ruta,
None;
R. Garcia-Monaco,
None;
E. Soriano,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/ultrasound-assessment-of-both-hands-in-fibromyalgia-patients-what-could-we-detect/