{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T16:58:00Z","timestamp":1780678680189,"version":"3.54.1"},"reference-count":17,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,2,6]]},"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:p>A 60-year-old woman with rheumatoid arthritis consulted for acute flare. She had elevated disease activity score 28 - erythrocyte sedimentation rate (DAS 28-ESR) of 6.88 and clinical disease activity index (CDAI) of 32. Her 12-joint ultrasound revealed widespread joint effusion. Synovial vascularity scores measured through superb microvascular imaging (SMI) and power Doppler were universally increased. We documented her treatment response 2\u2009weeks after she received a single dose of biosimilar infliximab using clinical and sonographic data. Her DAS 28-ESR and CDAI scores decreased to 4.21 and 7.0, respectively. Reduction in synovial vascularity scores was demonstrated using SMI. While there was near total resolution in joint effusion and tenosynovitis, SMI was able to demonstrate synovial vascularity in joints with no clinical swelling nor tenderness. Musculoskeletal ultrasound and superb microvascular imaging are useful adjuncts in evaluating synovitis in rheumatoid arthritis and documenting treatment response through documentation of synovial vascularity, effusion and tenosynovitis.<\/jats:p>","DOI":"10.1136\/bcr-2020-239112","type":"journal-article","created":{"date-parts":[[2021,2,18]],"date-time":"2021-02-18T11:04:52Z","timestamp":1613646292000},"page":"e239112","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Musculoskeletal ultrasound using superb microvascular imaging documents treatment response to biosimilar infliximab in rheumatoid arthritis"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4614-8436","authenticated-orcid":false,"given":"Julian Alejandro","family":"Santos","sequence":"first","affiliation":[{"name":"Department of Radiology, Philippine General Hospital, Manila, Metro Manila, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cherica Afurong","family":"Tee","sequence":"additional","affiliation":[{"name":"Division of Pediatric Rheumatology, Department of Pediatrics, Philippine General Hospital, Manila, Metro Manila, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romelito Jose Galvan","family":"Galsim","sequence":"additional","affiliation":[{"name":"Department of Radiology, Philippine General Hospital, Manila, Metro Manila, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0113-8290","authenticated-orcid":false,"given":"Michael Lucas","family":"Tee","sequence":"additional","affiliation":[{"name":"Department of Physiology, University of the Philippines Manila College of Medicine, Manila, Metro Manila, Philippines"},{"name":"Division of Rheumatology, Department of Medicine, Philippine General Hospital, Manila, Metro Manila, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,2,18]]},"reference":[{"key":"2025082707363774000_14.2.e239112.1","unstructured":"Jameson JL , Kasper D , Longo D . Harrison\u2019s Principles of Internal Medicine. 20th edn. 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EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update Annals of the rheumatic diseases 2020;79:685\u201399."},{"key":"2025082707363774000_14.2.e239112.10","doi-asserted-by":"crossref","first-page":"46","DOI":"10.3390\/jpm9040046","article-title":"Using the immunophenotype to predict response to biologic drugs in rheumatoid arthritis","volume":"9","year":"2019","journal-title":"J Pers Med"},{"key":"2025082707363774000_14.2.e239112.11","doi-asserted-by":"crossref","first-page":"1885","DOI":"10.1007\/s00296-018-4112-3","article-title":"Superb microvascular imaging (SMI) for evaluating hand joint lesions in patients with rheumatoid arthritis in clinical remission","volume":"38","author":"Yu","year":"2018","journal-title":"Rheumatol Int"},{"key":"2025082707363774000_14.2.e239112.12","unstructured":"Brant W , Helms C . Fundamentals of diagnostic radiology. 4th edn. Philadelphia. Pensylvannia. 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