The objective of this study is to assess the prevalence, localization, and severity of bone erosions on radiography (RX) and ultrasonography (US) according to ACPA status in patients with rheumatoid arthritis (RA). 78 patients with ACPA-positive (ACPA+) RA and 30 patients with ACPA-negative (ACPA-) RA fulfilling the ACR 1987 and/or ACR/EULAR 2010 criteria were consecutively included. On RX, a modified Sharp erosion score (SHSe) was evaluated by two blinded readers and one adjudicator for discordant cases (number of eroded joints ≤ three). On US, erosions were scored on six bilateral joints (MCP2, 3, 5; MTP2, 3, 5) with a four-point scale to calculate the total US score for erosions (USSe). The mean total SHSe and USSe were 3.7 and 4.4 times higher in the ACPA+ group than in the ACPA- group, respectively (P < 0.001). On both RX and US, the most discriminating joint between the two groups was MTP5, especially in cases with bilateral erosion. Based on multivariate analyses, ACPA + status was associated with erosive RA on RX according to the EULAR 2013 definition criteria [OR 4.4 (95% CI 1.2-16.4)], and on US according to the following two definitions: the presence of at least two eroded joint facets [OR 3.7 (95% CI 1.4-9.9)] or at least one grade 2 joint facet erosion [OR 9.0 (95% CI 2.8-28.4)]. Compared to ACPA- RA, ACPA + RA is associated independently with more severe erosive disease on RX and US. Both US and RX bilateral erosions in MTP5 joints are highly discriminant for ACPA + RA patients (97.8% in US and 100% in RX).

中文翻译：

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ACPA阳性与ACPA阴性类风湿关节炎：X线和超声检查中两个不同的糜烂性疾病。

这项研究的目的是根据类风湿关节炎（RA）患者的ACPA状况评估放射线照相（RX）和超声检查（US）上骨侵蚀的发生率，位置和严重程度。连续纳入符合ACR 1987和/或ACR / EULAR 2010标准的78例ACPA阳性（ACPA +）RA患者和30例ACPA阴性（ACPA-）RA患者。在RX上，由两名不知情的读者和一名陪审员针对不一致的情况（侵蚀关节数量≤3）评估改良的Sharp侵蚀评分（SHSe）。在美国，对四个双边关节（MCP2、3、5，MTP2、3、5）的侵蚀进行了评分，并采用四分制评分，以计算美国侵蚀总得分（USSe）。ACPA +组的平均总SHSe和USSe分别比ACPA-组高3.7倍和4.4倍（P <0.001）。在RX和US上，两组之间最有区别的关节是MTP5，特别是在双侧糜烂的情况下。根据多变量分析，根据EULAR 2013定义标准[OR 4.4（95％CI 1.2-16.4）]，以及在美国根据以下两个定义，ACPA +状态与RX上的糜烂性RA相关：两个侵蚀的关节面[OR 3.7（95％CI 1.4-9.9）]或至少一个2级关节面侵蚀[OR 9.0（95％CI 2.8-28.4）]。与ACPA-RA相比，ACPA + RA与RX和US上更严重的糜烂性疾病独立相关。对于ACPA + RA患者，MTP5关节的美国和RX双边侵蚀都具有很高的判别力（美国为97.8％，RX为100％）。根据EULAR 2013定义标准[OR 4.4（95％CI 1.2-16.4）]，ACPA +状态与RX上的糜烂性RA相关；根据以下两个定义，在US上，ACPA +状态与糜烂性RA相关：至少存在两个糜烂的关节面[ OR 3.7（95％CI 1.4-9.9）]或至少一种2级关节小面侵蚀[OR 9.0（95％CI 2.8-28.4）]。与ACPA-RA相比，ACPA + RA与RX和US上更严重的糜烂性疾病独立相关。对于ACPA + RA患者，MTP5关节的美国和RX双边侵蚀都具有很高的判别力（美国为97.8％，RX为100％）。根据EULAR 2013定义标准[OR 4.4（95％CI 1.2-16.4）]，ACPA +状态与RX上的糜烂性RA相关；根据以下两个定义，在US上，ACPA +状态与糜烂性RA相关：至少存在两个糜烂的关节面[ OR 3.7（95％CI 1.4-9.9）]或至少一种2级关节小面侵蚀[OR 9.0（95％CI 2.8-28.4）]。与ACPA-RA相比，ACPA + RA与RX和US上更严重的糜烂性疾病独立相关。对于ACPA + RA患者，MTP5关节的美国和RX双边侵蚀都具有很高的判别力（美国为97.8％，RX为100％）。与ACPA- RA相比，ACPA + RA与RX和US上更严重的糜烂性疾病独立相关。对于ACPA + RA患者，MTP5关节的美国和RX双边侵蚀都具有很高的判别力（美国为97.8％，RX为100％）。与ACPA-RA相比，ACPA + RA与RX和US上更严重的糜烂性疾病独立相关。对于ACPA + RA患者，MTP5关节的美国和RX双边侵蚀都具有很高的判别力（美国为97.8％，RX为100％）。