الفهرس 
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Abstract
Chronic-inflammatory arthritis such as rheumatoid arthritis (RA) can lead to severe joint damage. Disease progress is determined by the time of diagnosis, early onset of therapy, disease activity, genetic factors, and autoantibodies positivity (Vastesaeger et al., 2009). In order to prevent structural damage, it is necessary to monitor treatment response in RA patients. Besides clinical and serological assessments, musculoskeletal ultrasound (US) is now an important tool in the diagnosis and monitoring of disease progress. Ultrasound is suitable to measure both disease activity and structural damage. To justify the use of expensive medication such as biologics, it is essential to monitor treatment response. This can be accomplished by the measurement of disease activity in US, using grey-scale (GS) and power Doppler (PD) mode for synovitis and tenosynovitis. It is also possible to visualize certain bone lesions such as erosions, representing structural damage (Fukae et al., 2011).
This study aimed to determine the correlation between different indices used to assess the activity and severity of RA and to determine the value of recent indices using musculoskeletal ultrasonography in detecting synovitis. We also aimed to investigate differences in BMI in RA patients and their correlations with serum adiponectin and articular indices.
Fifty rheumatoid arthritis (RA) patients were included in this study and were subjected to: full history taking, clinical examination, laboratory investigations (ESR, CRP, RF, serum adiponectin level), plain X-ray of both hands and wrists, and musculoskeletal ultrasound examination (according to US DAS and US 7 joint scores). Results of serum adiponectin were also obtained for 25 healthy age- and sex-matched volunteers and served as controls.
Patients were grouped according to the cutoff values of US DAS into 3 groups (remission and low activity, moderate activity and high activity) being compared as regards different clinical, laboratory, disability and imaging scores. They were also grouped according to BMI into 3 groups (normal BMI, overweight and obese) which were also compared as regards different disease activity scores.
In this study, we found significantly positive correlations between different clinical disease activity and disability indices, and imaging scores (SENS, US DAS and US 7). Demonstrating that all activity indices used in our study (DAS 28-ESR, CDAI, GAS, and RAPID 3) are accurately reflect disease activity, and can discriminate between low, moderate, and high disease activity states; but they rely on subjective clinical symptoms and joint examination findings with a high interobserver variance. While, US-based assessment of disease activity is more accurate than composite indices and radiographic score (SENS) especially in detecting subclinical synovitis and erosions.