{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T22:54:56Z","timestamp":1782514496965,"version":"3.54.5"},"reference-count":40,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Lupus Sci Med"],"accepted":{"date-parts":[[2016,11,5]]},"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To assess the prevalence and severity of ultrasonographic abnormalities of the hand and wrist of asymptomatic patients with systemic lupus erythematosus (SLE) and compare these findings with those from patients with SLE with musculoskeletal signs or symptoms and healthy controls.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a prospective cross-sectional study that evaluated bilaterally, with grey-scale and power Doppler (PD) ultrasound (US), the dorsal hand (2nd to 5th metacarpophalangeal and 2nd to 5th proximal interphalangeal joints) and wrist (radiocarpal, ulnocarpal and intercarpal joints) of 30 asymptomatic patients with SLE, 6 symptomatic patients with SLE and 10 controls. Synovial hypertrophy (SH) and intra-articular PD signal were scored using semiquantitative grading scales (0\u20133). Individual scores were graded as normal (SH\u22641 and PD=0) or abnormal (SH\u22652 or PD\u22651). Global indexes for SH and PD were also calculated. US findings were correlated with clinical and laboratory data and disease activity indexes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>US detected SH (score \u22651) in 77% asymptomatic patients with SLE, mostly graded as minimal (score 1: 63%). 23% of the asymptomatic patients with SLE showed abnormal US PD findings (SH\u22652 or PD\u22651). SH was present in all symptomatic patients with SLE, mostly graded as moderate (grade 2: 67%), and with associated PD signal (83%). SH (score 1) was identified in 50% of controls, however, none presented abnormal US PD findings. SH index in the asymptomatic SLE group was higher than in the control group (2.0 (0\u20135) vs 0.5 (0\u20132), median (range), p=0.01) and lower than in the symptomatic SLE group (7.0 (4\u201323), median (range), p&lt;0.001). No significant correlation was demonstrated between US PD findings and clinical or laboratory variables and disease activity indexes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>A small subgroup of asymptomatic patients with SLE may present subclinical joint inflammation. Global US scores and PD signal may be important in disease evaluation and therapeutic monitoring.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/lupus-2016-000184","type":"journal-article","created":{"date-parts":[[2017,1,19]],"date-time":"2017-01-19T21:01:24Z","timestamp":1484859684000},"page":"e000184","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["Ultrasound detects subclinical joint inflammation in the hands and wrists of patients with systemic lupus erythematosus without musculoskeletal symptoms"],"prefix":"10.1136","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9663-0335","authenticated-orcid":false,"given":"Carina A","family":"Ruano","sequence":"first","affiliation":[{"name":"Radiology Department, Hospital de Santo Ant\u00f3nio dos Capuchos, Centro Hospitalar de Lisboa Central (CHLC), Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Malheiro","sequence":"additional","affiliation":[{"name":"Autoimmune Disease Unit, Unidade de Doen\u00e7as Auto-imunes\/Servi\u00e7o Medicina 3, Hospital de Santo Ant\u00f3nio dos Capuchos, CHLC, Lisbon, Portugal"},{"name":"N\u00facleo de Estudos de Doen\u00e7as Auto-imunes da Sociedade Portuguesa de Medicina Interna (NEDAI\/SPMI), Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o F","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Autoimmune Disease Unit, Unidade de Doen\u00e7as Auto-imunes\/Servi\u00e7o Medicina 3, Hospital de Santo Ant\u00f3nio dos Capuchos, CHLC, Lisbon, Portugal"},{"name":"N\u00facleo de Estudos de Doen\u00e7as Auto-imunes da Sociedade Portuguesa de Medicina Interna (NEDAI\/SPMI), Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Pinheiro","sequence":"additional","affiliation":[{"name":"Autoimmune Disease Unit, Unidade de Doen\u00e7as Auto-imunes\/Servi\u00e7o Medicina 3, Hospital de Santo Ant\u00f3nio dos Capuchos, CHLC, Lisbon, Portugal"},{"name":"N\u00facleo de Estudos de Doen\u00e7as Auto-imunes da Sociedade Portuguesa de Medicina Interna (NEDAI\/SPMI), Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu\u00eds S","family":"Vieira","sequence":"additional","affiliation":[{"name":"Radiology Department, Hospital de Santo Ant\u00f3nio dos Capuchos, Centro Hospitalar de Lisboa Central (CHLC), Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Francisca","family":"Moraes-Fontes","sequence":"additional","affiliation":[{"name":"N\u00facleo de Estudos de Doen\u00e7as Auto-imunes da Sociedade Portuguesa de Medicina Interna (NEDAI\/SPMI), Lisbon, Portugal"},{"name":"Autoimmune Disease Unit, Unidade de Doen\u00e7as Auto-imunes\/Servi\u00e7o Medicina 7.2, Hospital Curry Cabral, CHLC, Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,1,19]]},"reference":[{"key":"2025091511422556000_4.1.e000184.1","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1016\/j.berh.2009.04.003","article-title":"Lupus arthritis","volume":"23","author":"Grossman","year":"2009","journal-title":"Best Pr Res Clin Rheumatol"},{"key":"2025091511422556000_4.1.e000184.2","doi-asserted-by":"crossref","first-page":"1432","DOI":"10.1002\/art.24108","article-title":"Hand function and performance of daily activities in systemic lupus erythematosus","volume":"59","author":"Malcus Johnsson","year":"2008","journal-title":"Arthritis Rheum"},{"key":"2025091511422556000_4.1.e000184.3","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ker381"},{"key":"2025091511422556000_4.1.e000184.4","doi-asserted-by":"publisher","DOI":"10.1136\/ard.57.9.540"},{"key":"2025091511422556000_4.1.e000184.5","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.autrev.2014.08.007","article-title":"The role of imaging in the evaluation of joint involvement in 102 consecutive patients with systemic lupus erythematosus","volume":"14","author":"Mosca","year":"2015","journal-title":"Autoimmun Rev"},{"key":"2025091511422556000_4.1.e000184.6","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keh215"},{"key":"2025091511422556000_4.1.e000184.7","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200109)44:9<2018::AID-ART350>3.0.CO;2-C"},{"key":"2025091511422556000_4.1.e000184.8","doi-asserted-by":"publisher","DOI":"10.1002\/art.11245"},{"key":"2025091511422556000_4.1.e000184.9","first-page":"759","article-title":"Ultrasound imaging for the rheumatologist XVII. 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