AB1207 Correlation between clinical findings and ultrasonography in evaluating painful rheumatoid shoulder. (12th June 2018)

• Record Type: Journal Article
• Authors: Abdel Zaher, M.; Tharwat, S.; Abdel khalek, A.; Abdel salam, A.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 1703
• Page End: 1703
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.4714
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Shoulder pain is one of the most common complaints encountered in patients with rheumatoid arthritis (RA) 1 . In recent years ultrasonography (US) became an essential tool in diagnosing rheumatic diseases 2 . As clinical examination often does not allow an exact diagnosis, the agreement between both methods needs to be discussed to know how much the US add benefits to clinical examination. Objectives: To determine the agreement between clinical examination and ultrasound in evaluating shoulder pain in rheumatoid. Methods: A cross-sectional study including thirty RA patients, meeting the ACR/EULAR classification criteria for RA complaining of shoulder pain. They were recruited from rheumatology outpatient clinic in Mansoura University Hospitals. The sixty shoulders of the thirty patients were examined clinically by inspection, palpation and special tests, then fully examined by ultrasound including biceps tendon, subacromial bursa, rotator cuff tendons and acromioclavicular joint. Results: Agreement among clinical examination and US was examined using Cohen's kappa. There was slight agreement between clinical examination and US regarding biceps tenosynovitis with k=0.206, fair agreement regarding acromioclavicular osteoarthritis with k=0.392 and SASD bursitis with k=0.233. There was also moderate agreement between clinical examination and US examination of the shoulder in case of supraspinatus tendinopathy with k=0.464. Data were statistically significant (p<0.001). The overall agreement between clinical examination and ultrasound was poor. Conclusions: Clinical examination of shoulder pain in rheumatoid arthritis is not accurate, insufficient. It should be confirmed with US examination during the initial evaluation of the shoulder to give reliable data and differentiate between different pathologies. References: [1] Amin M, Ismail F, El-shereef R. The Role of Ultrasonography in Early Detection and Monitoring of Shoulder Erosions and Disease Activity in Rheumatoid Arthritis Patients; Comparison with MRI Examination. Acid Radiol2012;19(6):693–700. [2] Plaza M, Nowakowska-Plaza A., Pracon G., Sudol-szopinska I. Role of ultrasonography in the diagnosis of rheumatic diseases in light of ACR/EULAR guidelines. Journal of ultrasonography2016;16, 55. Disclosure of Interest: None declared