The Profile Of Musculoskeletal Ultrasonography In Patients With Adult Onset Still Disease

Background Adult onset Still disease (AoSD) is a systemic inflammatory disease and characterized by daily spiking high fevers accompanied by a rash, arthritis, and systemic manifestations. The clinical course of AoSD can be divided into three patterns; monophasic pattern, polycyclic pattern, and chronic articular pattern. Especially in chronic articular pattern, patients may have severe, destructive arthritis. Although chronic articular pattern was mimicking RA, there was a few reports that mentioned about the finding of musculoskeletal ultrasonography of AoSD. Objectives To examine the profile of musculoskeletal ultrasonography (MSUS) in patients with AoSD. Methods Twenty-seven cases of 20 patients with AoSD were enrolled, who consulted to our department between 2003 and 2012. Laboratory data, physical findings, and medication were collected. Using MSUS, semi-quantitative evaluation by gray scale and power Doppler were performed. Results There are 35 patients with adult onset Still disease in our department (10 male and 25 female). Median age of onset was 49.5. The proportion of clinical course was as about as follows; monophasic 22.2%, polycyclic 55.6%, and chronic articular 22.2%, respectively. On the background of MSUS, 10 cases were male and 17 cases were female. The onset age was 57.5 years old (median). The positive rate of CRP, ferritin, and LDH was 81.0%, 93.3%, and 29.4%, respectively. In MSUS, the positive rate of GS was 34.8% in MCP, 26.2% in PIP, 50.0% in hand, and 20.7% in knee joints respectively. The positive rate of PD was 19.0%, 5.8%, 42.6%, and 22.4%, respectively. The average of GS score was 1.1±0.1, 0.8±0.1, 1.3±0.2 and 0.7±0.1, respectively. The average of PD score was 0.5±0.1, 0.2±0.1, 1.1±0.1, and 0.1±0.1, respectively. Coefficient of correlation between ferritin and GS score of hand joints was higher than other joints (0.424). Correlation between ferritin and PD score of hand joint was also higher than other joints. Image/graph Conclusions The positive rate of GS was higher than PD in patients with adult onset Still disease. GS and PD signals were frequently observed in hand joints and were correlated with the level of ferritin. Disclosure of Interest None Declared