{
  "abstract": "Objective To evaluate the discriminatory performance of shear wave elastography (SWE) for detecting ultrasound-confirmed wrist synovitis in rheumatoid arthritis (RA), derive preliminary diagnostic cut-offs and examine associations between synovial stiffness and ultrasound inflammatory burden.Methods This cross-sectional pilot study included 133 participants: 60 patients with RA and ultrasound-confirmed synovitis, 30 patients with RA without ultrasound-confirmed synovitis, 30 healthy controls and 13 individuals with wrist ganglia. Bilateral radiocarpal and midcarpal recesses were assessed using B-mode ultrasound, power Doppler (PD) and SWE. Ultrasound-confirmed synovitis was prespecified as synovial hypertrophy (SH) grade ≥2, irrespective of PD. Associations between SWE and ultrasound inflammatory burden were assessed using recess-level linear mixed-effects models and participant-level analyses.Results Participant-level mean SWE showed high discriminatory performance within this pilot cohort for ultrasound-confirmed synovitis: area under the curve (AUC) 0.998 for kPa, with an optimal cut-off of 19.49 kPa (98.3% sensitivity; 100% specificity) and AUC 0.994 for m/s, with an optimal cut-off of 2.89 m/s (95.0% sensitivity; 100% specificity). Mean SWE was significantly higher in patients with ultrasound-confirmed synovitis than in all other groups (p<0.001). At the recess level, SWE increased progressively with wrist-adapted Global Outcome Measures in Rheumatology (OMERACT)-European Alliance of Associations for Rheumatology (EULAR) Synovitis Score, SH and PD grades (all p<0.001). After adjustment for Disease Activity Score in 28 joints using erythrocyte sedimentation rate, age, disease duration, current conventional synthetic disease-modifying antirheumatic drug use and current biologic disease-modifying antirheumatic drug use, wrist-adapted GLOESS mean and PD mean were independently associated with SWE.Conclusion SWE showed high discriminatory performance for ultrasound-confirmed synovitis within this single-operator pilot cohort and was closely associated with ultrasound inflammatory burden. The preliminary diagnostic cut-offs require independent validation, including assessment of interobserver reproducibility, before clinical implementation.",
  "abstract_shown": true,
  "affiliations": [
    "IDIBAPS and Faculty of Medicine, University of Barcelona, Barcelona, Spain",
    "Rheumatology Department, Hospital Clínic Barcelona, Barcelona, Spain",
    "Department of Radiology, Hospital del Mar, Barcelona, Spain",
    "Faculty of Health and Life Sciences, School of Medicine, International University of Ecuador, Quito, Ecuador",
    "Department of Orthopaedics and Trauma Surgery, Hospital Clínic Barcelona, Barcelona, Spain"
  ],
  "article_type": null,
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  "author_total": 17,
  "authors": [
    {
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        0
      ],
      "name": "Julio Ramírez"
    },
    {
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        1
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      "name": "Raimon Sanmartí"
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    {
      "affs": [
        1
      ],
      "name": "Virginia Ruiz-Esquide"
    },
    {
      "affs": [
        1
      ],
      "name": "José A Gómez-Puerta"
    },
    {
      "affs": [
        1
      ],
      "name": "Ana Belen Azuaga"
    },
    {
      "affs": [
        2
      ],
      "name": "Salvatore Marsico"
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    {
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        1
      ],
      "name": "Helena Florez"
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        3
      ],
      "name": "Miguel Martín-Mateo"
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    {
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        1
      ],
      "name": "Beatriz Frade-Sosa"
    },
    {
      "affs": [
        1
      ],
      "name": "Juan-Camilo Sarmiento-Monroy"
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    {
      "affs": [
        1
      ],
      "name": "Andrés Ponce"
    },
    {
      "affs": [
        1
      ],
      "name": "Sandra Farietta-Varela"
    },
    {
      "affs": [
        1
      ],
      "name": "Patricia Corzo"
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    {
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        4
      ],
      "name": "Laia Sabaté-Cequier"
    },
    {
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        1
      ],
      "name": "Claudia Arango"
    },
    {
      "affs": [
        1
      ],
      "name": "Joshua Peñafiel-Sam"
    },
    {
      "affs": [
        1
      ],
      "name": "Andrea Zacarías"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/339s2n2wdhqm8.bib",
  "cited_by": 0,
  "doi": "10.1136/rmdopen-2026-007652",
  "fulltext_url": "https://rmdopen.bmj.com/content/12/4/e007652.full",
  "id": "339s2n2wdhqm8",
  "issns": [
    "2056-5933"
  ],
  "landing_url": "https://doi.org/10.1136/rmdopen-2026-007652",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
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      "2741|Ultrasound Imaging and Elastography"
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  "pdf_url": "https://rmdopen.bmj.com/content/12/4/e007652.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-08",
  "publisher": "BMJ Publishing Group",
  "ris": "https://research.draconitic.com/paper/339s2n2wdhqm8.ris",
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    {
      "first_seen": "2026-11-09T14:21:26Z",
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  "title": "Quantitative assessment of synovial inflammation in rheumatoid arthritis using shear wave elastography: a pilot study",
  "title_text": "Quantitative assessment of synovial inflammation in rheumatoid arthritis using shear wave elastography: a pilot study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T14:21:26Z",
  "url": "https://research.draconitic.com/paper/339s2n2wdhqm8",
  "venue": "RMD Open",
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