Diagnostic potential of ultrasound in systemic lupus erythematosus patients with joint involvement: Relation to anticyclic citrullinated peptide (anti-CCP), disease activity and functional status

Abstract Aim of the work : To assess the pattern of joint involvement in systemic lupus erythematosus (SLE) patients by ultrasound (US) and to detect their relation with clinical, laboratory, disease activity and functional status. Patients and methods : Thirty SLE patients and 20 controls were included. SLE disease activity index (SLEDAI-2k) and health assessment questionnaire-disability index (HAQ-DI) were assessed. Anti-cyclic citrullinated peptide (anti-CCP) was measured. Arthritis was evaluated clinically and by musculoskeletal ultrasonography (MSUS) including grey-scale-US (GSUS) and power Doppler-US (PDUS). Results : The mean age of the patients was 28.9 ± 8.7 years (28 females and 2 males) with disease duration of 8.9 ± 1.7 years. Arthritis was detected clinically in 18 patients, MSUS detected synovitis in 20; tenosynovitis was clinically found in 50% and in 56.7% by MSUS. 10 patients with arthritis had PD signals and 7 had erosions. Anti-CCP was positive in 4 patients with arthritis; 3 were erosive. RF was positive in 6; 3 of them erosive. Anti-CCP significantly correlated with PDUS, erosions and tenosynovitis (r = 0.45, p = 0.01; r = 0.37, p = 0.046 and r = 0.48, p = 0.007 respectively). SLEDAI-2k significantly correlated with GSUS, PDUS, erosions, tenosynovitis (r = 0.52, p = 0.003; r = 0.77, p  Conclusion : Erosive arthritis can be detected in SLE patients with arthritis and have an impact on disease activity and functional status. Anti-CCP can also be detected in SLE and is associated with erosive arthritis. MSUS findings including; synovitis, tenosynovitis and PD signals also have an impact on disease activity and functional ability in SLE patients.