BRIEF RESEARCH REPORT article
Front. Med.
Sec. Rheumatology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1564381
The EULAR-OMERACT joint-level scoring of ultrasound synovitis demonstrates good construct validity when tested at the patient-level in comparison with measures of disease activity and joint damage in patients with rheumatoid arthritis
Provisionally accepted
York Kiat Tan1,2,3*
Julian Thumboo2,3,4- 1Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore, Singapore
- 2Duke-NUS Medical School, Singapore, Singapore
- 3Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- 4Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
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Objective: Patient-level ultrasound joint inflammation outcomes derived from the European Alliance of Associations for Rheumatology-Outcome Measures in Rheumatology (EULAR-OMERACT) joint-level scoring of elementary components and combined score (CS) were compared with measures of disease activity and joint damage in patients with rheumatoid arthritis (RA).Methods: Clinical joint assessment and a 22-joint (bilateral hands/wrists) ultrasonography were performed independently during the same patient study visit. Patient-level ultrasound joint inflammation outcomes (total power Doppler (PD) score, total grey-scale (GS) score, total CS, number of joint(s) with CS≥2 (at least moderate synovitis) and number of joint(s) with ultrasound synovitis defined as PD>0 or GS≥2) derived from the EULAR-OMERACT joint-level scoring system were correlated with Clinical Disease Activity Index (CDAI), 28-joint disease activity score (DAS28) and ultrasound-detected joint damage, i.e. total bone erosion score (TBES). The relationship between variables were studied using simple linear regression.Results: Eighty-three RA patients had 1826 joints scanned in this cross-sectional study. All patient-level ultrasound joint inflammation outcomes correlated significantly (P<0.01) with CDAI, DAS28 and TBES (correlation coefficient ranging from 0.45 to 0.48, 0.38 to 0.45 and 0.66 to 0.83, respectively). Linear regression revealed a statistically significant relationship (P<0.01) for all patient-level ultrasound joint inflammation outcomes versus CDAI, DAS28 and TBES (regression coefficient ranging from 0.603 to 1.260, 0.066 to 0.149 and 0.416 to 0.818, respectively).Patient-level ultrasound joint inflammation outcomes derived from the EULAR-OMERACT joint-level scoring system showed good construct validity in comparison with both disease activity and joint damage in patients with RA.
Keywords: Synovitis, Rheumatoid arthritis, ultrasound, Joints, Bone erosion
Received: 21 Jan 2025; Accepted: 23 Apr 2025.
Copyright: © 2025 Tan and Thumboo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: York Kiat Tan, Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore, Singapore
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