Introduction: The definition of remission in Rheumatoid Arthritis (RA) is still difficult
to determine. An ultrasound of the hands may be important in helping confirm clinical remission.
Objective: This study’s aim was to evaluate the interest in using an ultrasound of the hands to confirm
clinical remission, as well as comparing the various remission scores (DAS 28 VS, DAS 28
CRP, and SDAI) and the ultrasound data, in order to deduce the most accurate score to confirm this
Methods: In this prospective monocentric study, we studied patients with rheumatoid arthritis in
clinical remission, according to DAS 28 VS, for at least 3 months without corticosteroid therapy.
An ultrasound mode B / Doppler of the hands was taken by an experienced rheumatologist, involving
22 joints: wrists, Metacarpophalangeal (MCP) joints and proximal interphalangeal joints (PPI)
Results: Fifty-one patients were included. They were classified in remission according to DAS 28
VS as well as DAS 28 CRP, whereas the remission according to SDAI was achieved in 66.7% of
our patients. Synovial hypertrophy and power Doppler were present in respectively 65% and 25%
of the patients. SDAI was the most accurate score to confirm RA remission (p < 0.003).
Conclusion: SDAI appears to be the most appropriate score for the definition of remission in
rheumatoid arthritis, but despite the use of the latter, ultrasound synovitis may still be present. Further
work deserves to be done to clarify the value of ultrasound evaluation in the definition of RA