{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:03:55Z","timestamp":1770077035255,"version":"3.49.0"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,8,19]],"date-time":"2016-08-19T00:00:00Z","timestamp":1471564800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2018,1]]},"abstract":"Abstract<\/jats:title>Objective<\/jats:title>To determine the utility of ultrasonography in guiding modification of disease\u2010modifying anti\u2010rheumatic drug (DMARD<\/jats:styled-content>) and steroid therapy for inflammatory arthritis (IA<\/jats:styled-content>) in routine clinical practice.<\/jats:p><\/jats:sec>Methods<\/jats:title>In this retrospective study, we analyzed DMARD<\/jats:styled-content> and steroid use in IA<\/jats:styled-content> patients referred to a rheumatologist\u2010led ultrasound clinic. Power Doppler (PD<\/jats:styled-content>) vascularity and greyscale (GS<\/jats:styled-content>) synovial hypertrophy joint findings were categorized as positive\/negative for each patient. The erythrocyte sedimentation rate (ESR<\/jats:styled-content>) was used as a measure of disease activity.<\/jats:p><\/jats:sec>Results<\/jats:title>We assessed single visit data for 46 adult IA<\/jats:styled-content> patients: 67.4% (n<\/jats:italic> = 31) rheumatoid arthritis (RA<\/jats:styled-content>), 15.2% (n<\/jats:italic> = 7) psoriatic arthritis, 10.9% (n<\/jats:italic> = 5) spondyloarthritis, and 6.5% (n<\/jats:italic> = 3) undifferentiated IA<\/jats:styled-content>. The mean ESR<\/jats:styled-content> was 28.8 mm\/h. Thirty\u2010seven patients with both GS<\/jats:styled-content> and PD<\/jats:styled-content> ultrasound results were subsequently analyzed. All patients (n<\/jats:italic> = 10) escalated and\/or initiated on DMARD<\/jats:styled-content> and 9\/10 patients escalated or initiated on steroids were PD<\/jats:styled-content> and GS<\/jats:styled-content> positive. Six of seven patients with dose reduction and\/or cessation of DMARD<\/jats:styled-content>s and five of seven patients with dose reduction or cessation of steroids were PD<\/jats:styled-content> negative. Of six patients who were GS<\/jats:styled-content> positive and PD<\/jats:styled-content> negative, three had dose reduction and\/or cessation of DMARD<\/jats:styled-content>s, while four had dose reduction of steroids; none of the six patients had DMARD<\/jats:styled-content>\/steroid escalation.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>By clarifying joint inflammation in an IA<\/jats:styled-content> cohort with overall low ESR<\/jats:styled-content>, ultrasonography of physician\u2010selected joints can improve clinical assessment, resulting in treatment modification. Positive PD<\/jats:styled-content> findings were particularly influential, while the clinical significance of GS<\/jats:styled-content> positivity alone requires further investigation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1756-185x.12933","type":"journal-article","created":{"date-parts":[[2016,8,19]],"date-time":"2016-08-19T07:22:53Z","timestamp":1471591373000},"page":"155-160","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Utility of ultrasonography in guiding modification of disease modifying anti\u2010rheumatic drugs and steroid therapy for inflammatory arthritis in routine clinical practice"],"prefix":"10.1111","volume":"21","author":[{"given":"York Kiat","family":"Tan","sequence":"first","affiliation":[{"name":"Department of Rheumatology and Immunology Singapore General Hospital Singapore"},{"name":"Duke\u2010NUS Graduate Medical School Singapore"},{"name":"Yong Loo Lin School of Medicine National University of Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li\u2010Ching","family":"Chew","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology Singapore General Hospital Singapore"},{"name":"Duke\u2010NUS Graduate Medical School Singapore"},{"name":"Yong Loo Lin School of Medicine National University of Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"John C","family":"Allen","sequence":"additional","affiliation":[{"name":"Office of Clinical Sciences Duke\u2010NUS Graduate Medical School Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weng Kit","family":"Lye","sequence":"additional","affiliation":[{"name":"Office of Clinical Sciences Duke\u2010NUS Graduate Medical School Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei Lei","family":"Htay","sequence":"additional","affiliation":[{"name":"Rheumatology Department Yangon Specialty Hospital Yangon Myanmar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Hassan","sequence":"additional","affiliation":[{"name":"Internal Medicine Brooks Hospital \u2010 Alberta Health Services Brooks Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip G","family":"Conaghan","sequence":"additional","affiliation":[{"name":"Leeds Institute of Rheumatic and Musculoskeletal Medicine University of Leeds Leeds UK"},{"name":"NIHR Leeds Musculoskeletal Biomedical Research Unit Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julian","family":"Thumboo","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology Singapore General Hospital Singapore"},{"name":"Duke\u2010NUS Graduate Medical School Singapore"},{"name":"Yong Loo Lin School of Medicine National University of Singapore 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