<strong>Introduction</strong>: Rheumatoid arthritis (RA) is the most common chronic inflammatory rheumatism. The increasing use of bone and joint ultrasound as a tool to aid in the detection of unrefined s...<strong>Introduction</strong>: Rheumatoid arthritis (RA) is the most common chronic inflammatory rheumatism. The increasing use of bone and joint ultrasound as a tool to aid in the detection of unrefined synovitis in developed countries, has led us to study the performance of ultrasound in the diagnosis of RA in subjects consulting in rheumatology at Cotonou. <strong>Study Method:</strong> Descriptive cross-sectional study of patients with RA, selected on the basis of ACR/ EULAR 2010 criteria. A complete clinical examination with imaging including X-rays and ultrasounds of the hands and feet were performed in all patients who have given their consent. The data collected was analyzed using EPI data 3.1 and SPSS 24.0 software. The significance rate was defined with a p-value < 5%. Cohen’s Kappa (k) test was used to assess agreement. <strong>Results:</strong> All 53 patients included had lesions on ultrasound. Synovitis was found in 98.1% and bone erosions in 88.7%. There was no agreement in the wrists between clinical examination and ultrasound (k = <span style="white-space:nowrap;">-</span>0.116), MCP (k = <span style="white-space:nowrap;">-</span>0.097) and MTP (k = <span style="white-space:nowrap;">-</span>0.031). Agreement was very low at the PPI level (k = 0.03). It was low at the different sites, between ultrasound and radiographic detection of lesions (k between 0.022 - 0.22). Age, positive immunologic RA factor and biological inflammatory syndrome were associated with ultrasound erosions (p = 0.0001) and only age was associated with active synovitis (p = 0.022). <strong>Conclusion:</strong> Bone and articular ultrasound is a good complementary alternative to clinical examination and radiography diagnostic in early diagnosis of RA in our developing countries, in the absence of MRI which remains a luxury.展开更多
<strong>Introduction:</strong> Tendinopathy of the thoracic limb (TMT) is frequent, and is responsible for an important socio-professional handicap. Medical imaging, in particular, ultrasound has a major r...<strong>Introduction:</strong> Tendinopathy of the thoracic limb (TMT) is frequent, and is responsible for an important socio-professional handicap. Medical imaging, in particular, ultrasound has a major role in contributing to the diagnosis. As the use of ultrasound is recent in osteoarticular pathology, especially in Africa, we proposed to determine the contribution of imaging in the diagnosis of tendinopathy of the thoracic limbs in a country with limited resources. <strong>Patients and Method:</strong> A descriptive and analytical cross-sectional study of patients with tendinopathy of the thoracic limb who consulted the rheumatology department of the CNHU-HKM of Cotonou from August 6, 2019 to October 6, 2019. We evaluated the concordance of thoracic limb tendinopathy between imaging (radiography and ultrasound) and the clinic on the one hand and then between radiography and ultrasound on the other hand. The analysis of the collected data was carried out with the Epi-info software version 7.2.1.0. Then the concordance was evaluated by the kappa coefficient. <strong>Results:</strong> Fifty- two (52) patients with 104 joints were evaluated. The average age was 54.92 ± 3.40 years. Clinically, rotator cuff tendinopathy was the most frequent abarticular pathology (45.19%). The clinical-ultrasound agreement was strong (k = 0.7527) for the shoulders, very strong (k = 0.9360) for the elbows and moderate for the wrists (k = 0.6695). The clinical-radiographic agreement was weak (k = 0.2316) at the shoulder level and very weak (k = 0.2087) at the elbow level. The radio-ultrasound agreement was very low in the shoulders (k = 0.1522), elbows (k = 0.1859) and wrists (k = 0.0001). <strong>Conclusion:</strong> The contribution of imaging in the diagnosis of TMT remains certain even in a country with limited resources like ours. Ultrasound is a reliable examination for the diagnosis of non-traumatic tendinopathy of the thoracic limb with a good clinical-ultra- sound concordance and a weak radio-clinical and radio-ultrasound c展开更多
文摘<strong>Introduction</strong>: Rheumatoid arthritis (RA) is the most common chronic inflammatory rheumatism. The increasing use of bone and joint ultrasound as a tool to aid in the detection of unrefined synovitis in developed countries, has led us to study the performance of ultrasound in the diagnosis of RA in subjects consulting in rheumatology at Cotonou. <strong>Study Method:</strong> Descriptive cross-sectional study of patients with RA, selected on the basis of ACR/ EULAR 2010 criteria. A complete clinical examination with imaging including X-rays and ultrasounds of the hands and feet were performed in all patients who have given their consent. The data collected was analyzed using EPI data 3.1 and SPSS 24.0 software. The significance rate was defined with a p-value < 5%. Cohen’s Kappa (k) test was used to assess agreement. <strong>Results:</strong> All 53 patients included had lesions on ultrasound. Synovitis was found in 98.1% and bone erosions in 88.7%. There was no agreement in the wrists between clinical examination and ultrasound (k = <span style="white-space:nowrap;">-</span>0.116), MCP (k = <span style="white-space:nowrap;">-</span>0.097) and MTP (k = <span style="white-space:nowrap;">-</span>0.031). Agreement was very low at the PPI level (k = 0.03). It was low at the different sites, between ultrasound and radiographic detection of lesions (k between 0.022 - 0.22). Age, positive immunologic RA factor and biological inflammatory syndrome were associated with ultrasound erosions (p = 0.0001) and only age was associated with active synovitis (p = 0.022). <strong>Conclusion:</strong> Bone and articular ultrasound is a good complementary alternative to clinical examination and radiography diagnostic in early diagnosis of RA in our developing countries, in the absence of MRI which remains a luxury.
文摘<strong>Introduction:</strong> Tendinopathy of the thoracic limb (TMT) is frequent, and is responsible for an important socio-professional handicap. Medical imaging, in particular, ultrasound has a major role in contributing to the diagnosis. As the use of ultrasound is recent in osteoarticular pathology, especially in Africa, we proposed to determine the contribution of imaging in the diagnosis of tendinopathy of the thoracic limbs in a country with limited resources. <strong>Patients and Method:</strong> A descriptive and analytical cross-sectional study of patients with tendinopathy of the thoracic limb who consulted the rheumatology department of the CNHU-HKM of Cotonou from August 6, 2019 to October 6, 2019. We evaluated the concordance of thoracic limb tendinopathy between imaging (radiography and ultrasound) and the clinic on the one hand and then between radiography and ultrasound on the other hand. The analysis of the collected data was carried out with the Epi-info software version 7.2.1.0. Then the concordance was evaluated by the kappa coefficient. <strong>Results:</strong> Fifty- two (52) patients with 104 joints were evaluated. The average age was 54.92 ± 3.40 years. Clinically, rotator cuff tendinopathy was the most frequent abarticular pathology (45.19%). The clinical-ultrasound agreement was strong (k = 0.7527) for the shoulders, very strong (k = 0.9360) for the elbows and moderate for the wrists (k = 0.6695). The clinical-radiographic agreement was weak (k = 0.2316) at the shoulder level and very weak (k = 0.2087) at the elbow level. The radio-ultrasound agreement was very low in the shoulders (k = 0.1522), elbows (k = 0.1859) and wrists (k = 0.0001). <strong>Conclusion:</strong> The contribution of imaging in the diagnosis of TMT remains certain even in a country with limited resources like ours. Ultrasound is a reliable examination for the diagnosis of non-traumatic tendinopathy of the thoracic limb with a good clinical-ultra- sound concordance and a weak radio-clinical and radio-ultrasound c
