Avaliação ecodoppler nas sinovites como marcador precoce de artrite reumatóide

Abstract

INTRODUCTION: Doppler ultrasound is an effective tool for early detection of rheumatoid arthritis (RA), allowing the visualization of vascularization and hypertrophy of synovial tissue in a dynamic way. OBJECTIVES: To analyze the usefulness of Doppler ultrasonography, reinforcing it as a method for early evaluation of synovitis in patients with RA at the rheumatology service of the Regional Hospital of Augustinópolis, Tocantins, Brazil. METHODOLOGY: This is a quantitative cross-sectional, observational descriptive study based on field research. RESULTS: A total of 33 participants were evaluated, and it was observed that the majority were female (87.9%), under fifty years of age (54.5%), had completed high school (84.8%), earned between 1 and 2 minimum wages (72.7%) and one hundred percent of the sample did not have health insurance. Participants reported several comorbidities, especially hypertension (45.5%), smoking (33.3%), and diabetes (24.2%). The main factors related to RA include joint pain (97.0%), joint swelling (72.7%), and morning stiffness (63.6%). Most patients have RA for 1 to 5 years (54.5%). The most commonly used medications include methotrexate (81.8%), prednisone (72.7%), and NSAIDs (54.5%). Half of the patients tested positive for rheumatoid factor (RF) and most patients (53.8%) tested positive for anti-CCP antibodies. The vast majority of patients tested positive for ESR (89.3%) and CRP (85.2%). Synovitis is most prevalent in the wrist, followed by the MCF and PIP joints. There was no significant association between RF and negative or positive anti-CCP and Power Doppler grade in several joints examined (p > 0.05). Similar to synovitis, in the wrist, there is a tendency for RF-positive patients to have higher degrees of power Doppler activity compared to RF-negative patients, although this is not statistically significant (p = 0.16). However, for 2nd MTF, there is a statistically significant association between positive anti-CCP antibody and a higher degree of Power Doppler activity (p = 0.02). CONCLUSION: This research highlights the complexity and impact of RA, showing a sociodemographic profile marked by female predominance and comorbidities such as hypertension and diabetes. The use of Doppler ultrasound is promising for the early detection of synovitis, although no significant associations were found between markers such as RF and anti-CCP antibody with synovitis severity and power Doppler in all joints, trends are highlighted, underlining the importance of further studies.