Comparison between clinical and ultrasonographic assessment of arthritis in patients with hepatitis C virus infection versus rheumatoid arthritis patients / Sahar Soliman Emam Soliman Younis ; Supervised Amira Abdelsabour Shahin , Hala Lotfy Fayed , Aboelmagd Mohamed Elbohy

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Rheumatology and Rehabilitation

Objective: The present study was conducted to assess the musculoskeletal ultrasound findings in HCV infected patients with active arthritis and to show its relation with clinical manifestations in those patients. Also, to compare the clinical and the ultrasound findings in HCV infected patients having active arthritis with the clinical and the ultrasound findings in active rheumatoid arthritis patients. Methods: 30 patients with proven diagnosis of HCV presenting with active arthritis and not to have any other rheumatologic disease. In addition, 30 randomly selected active RA patients with no identified HCV infection and diagnosed according to ACR/EULAR 2010 classification criteria of RA served as the control group. All patients were subjected to full history taking, thorough clinical examination, laboratory investigations, assessment of disease activity and functional status ultrasonography assessment was done using the German US7 score. Results: significantly higher TJC, SJC, Ritchie articular index and VAS scores were observed in the RA group with mean values of (14.57±4.897), (7.5±3.78), (15.33±5.689) and (6.93±1.484) respectively. P-values were <0.001, <0.001, 0.039, and 0.026 respectively. Some articular manifestations like morning stiffness and were significantly higher in RA patients with mean value of 37.17±35.176 (P-value was 0.003). Hand deformities were only present in RA patients. Significantly higher US7 GS and PD synovitis scores, GS and PD tenosynovitis scores and erosion score were found in the RA group (P-values were <0.001, <0.001, 0.011, 0.008, and <0.001 respectively). However, GS synovitis was detected in 24 (80%) of the patients in the HCV group and PD synovitis was detected in 18 (60%) patients. No significant difference was found between treated and untreated groups of the HCV patients. The US7 GS and PD synovitis scores showed significant positive correlation with the SJC in the RA and HCV groups

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