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Detection of clinically manifest and silent synovitis in the hands and wrists by fluorescence optical imaging.

Kisten Y, Györi N, Af Klint E, Rezaei H, Levitsky A, Karlsson A, van Vollenhoven R - RMD Open (2015)

Bottom Line: Fluorescence optical imaging (FOI) is a novel modality based on the use of an intravenous fluorophore, which enables fluorescent imaging of the hands and wrists with increased focal optical signal intensities in areas of high perfusion and/or capillary leakage.The high degree of agreement between MSUS and FOI suggest its use in clinical practice, especially when MSUS is not available, in order to identify synovitis earlier and with greater confidence.FOI may be particularly useful in identifying patients with clinically non-apparent joint inflammation of the hands and/or wrists.

View Article: PubMed Central - PubMed

Affiliation: Unit for Clinical Therapy Research, Inflammatory Diseases (ClinTRID), Karolinska Institute, Karolinska University Hospital , Stockholm , Sweden.

ABSTRACT

Objectives: The correct identification of synovitis is critical for achieving optimal therapy results. Fluorescence optical imaging (FOI) is a novel modality based on the use of an intravenous fluorophore, which enables fluorescent imaging of the hands and wrists with increased focal optical signal intensities in areas of high perfusion and/or capillary leakage. The study objective was to determine the diagnostic utility of FOI in detecting apparent and clinically non-apparent active synovitis.

Methods: Bilateral hand and wrist joints (n=872) of 26 patients with inflammatory arthritis assessed by standard clinical examination, musculoskeletal ultrasound (MSUS) and FOI were studied. Synovitis was defined as tender and swollen joints on clinical examination, presence of synovial thickening and intra-articular Doppler signals on MSUS, and abnormal focal optical signal intensities on FOI, respectively. Subclinical synovitis was defined as being clinically non-apparent, but positively inflamed on MSUS.

Results: Depending on the standard used to define inflammation, FOI ranged from 73-83% sensitive and 83-95% specific for detecting manifest synovitis. For detecting clinically silent synovitis, the sensitivity, specificity and positive and negative predictive values of FOI were 80%, 96%, 77% and 97%, respectively.

Conclusions: The high degree of agreement between MSUS and FOI suggest its use in clinical practice, especially when MSUS is not available, in order to identify synovitis earlier and with greater confidence. FOI may be particularly useful in identifying patients with clinically non-apparent joint inflammation of the hands and/or wrists.

No MeSH data available.


Related in: MedlinePlus

Strengths of agreement and prevalence of synovitis (+) joints by clinical examination (clin+), musculoskeletal ultrasound (MSUS+) and fluorescence optical imaging (FOI+) in 872 hand and wrist joints of 26 inflammatory arthritis patients.
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RMDOPEN2015000106F1: Strengths of agreement and prevalence of synovitis (+) joints by clinical examination (clin+), musculoskeletal ultrasound (MSUS+) and fluorescence optical imaging (FOI+) in 872 hand and wrist joints of 26 inflammatory arthritis patients.

Mentions: Of the 872 joints evaluated, the prevalence of inflammation detection was 142 (16%), 241 (28%) and 229 (26%) by clinical examination, MSUS and FOI, respectively (figure 1).


Detection of clinically manifest and silent synovitis in the hands and wrists by fluorescence optical imaging.

Kisten Y, Györi N, Af Klint E, Rezaei H, Levitsky A, Karlsson A, van Vollenhoven R - RMD Open (2015)

Strengths of agreement and prevalence of synovitis (+) joints by clinical examination (clin+), musculoskeletal ultrasound (MSUS+) and fluorescence optical imaging (FOI+) in 872 hand and wrist joints of 26 inflammatory arthritis patients.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4612680&req=5

RMDOPEN2015000106F1: Strengths of agreement and prevalence of synovitis (+) joints by clinical examination (clin+), musculoskeletal ultrasound (MSUS+) and fluorescence optical imaging (FOI+) in 872 hand and wrist joints of 26 inflammatory arthritis patients.
Mentions: Of the 872 joints evaluated, the prevalence of inflammation detection was 142 (16%), 241 (28%) and 229 (26%) by clinical examination, MSUS and FOI, respectively (figure 1).

Bottom Line: Fluorescence optical imaging (FOI) is a novel modality based on the use of an intravenous fluorophore, which enables fluorescent imaging of the hands and wrists with increased focal optical signal intensities in areas of high perfusion and/or capillary leakage.The high degree of agreement between MSUS and FOI suggest its use in clinical practice, especially when MSUS is not available, in order to identify synovitis earlier and with greater confidence.FOI may be particularly useful in identifying patients with clinically non-apparent joint inflammation of the hands and/or wrists.

View Article: PubMed Central - PubMed

Affiliation: Unit for Clinical Therapy Research, Inflammatory Diseases (ClinTRID), Karolinska Institute, Karolinska University Hospital , Stockholm , Sweden.

ABSTRACT

Objectives: The correct identification of synovitis is critical for achieving optimal therapy results. Fluorescence optical imaging (FOI) is a novel modality based on the use of an intravenous fluorophore, which enables fluorescent imaging of the hands and wrists with increased focal optical signal intensities in areas of high perfusion and/or capillary leakage. The study objective was to determine the diagnostic utility of FOI in detecting apparent and clinically non-apparent active synovitis.

Methods: Bilateral hand and wrist joints (n=872) of 26 patients with inflammatory arthritis assessed by standard clinical examination, musculoskeletal ultrasound (MSUS) and FOI were studied. Synovitis was defined as tender and swollen joints on clinical examination, presence of synovial thickening and intra-articular Doppler signals on MSUS, and abnormal focal optical signal intensities on FOI, respectively. Subclinical synovitis was defined as being clinically non-apparent, but positively inflamed on MSUS.

Results: Depending on the standard used to define inflammation, FOI ranged from 73-83% sensitive and 83-95% specific for detecting manifest synovitis. For detecting clinically silent synovitis, the sensitivity, specificity and positive and negative predictive values of FOI were 80%, 96%, 77% and 97%, respectively.

Conclusions: The high degree of agreement between MSUS and FOI suggest its use in clinical practice, especially when MSUS is not available, in order to identify synovitis earlier and with greater confidence. FOI may be particularly useful in identifying patients with clinically non-apparent joint inflammation of the hands and/or wrists.

No MeSH data available.


Related in: MedlinePlus