Reproducibility of Joint Swelling Assessment by Sonography in Patients with Long-lasting Rheumatoid Arthritis (SEA-Repro Study Part II)

2010 ◽  
Vol 37 (5) ◽  
pp. 938-945 ◽  
Author(s):  
SANDRINE JOUSSE-JOULIN ◽  
MARIA ANTONIETTA d’AGOSTINO ◽  
THIERRY MARHADOUR ◽  
JEAN DAVID ALBERT ◽  
JACQUES BENTIN ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Physical Examination ◽  
Disease Activity Score ◽  
Power Doppler ◽  
Kappa Statistic ◽  
Reference Standard ◽  
Interobserver Reproducibility ◽  
Grading Systems ◽  
The Difference ◽  
Good Agreement

Objective.To evaluate the intraobserver and interobserver reproducibility of B-mode and power Doppler (PD) sonography in patients with active long-standing rheumatoid arthritis (RA) comparatively with clinical data.Methods.In each of 7 patients being considered for a change in their RA treatment regimen, 7 healthcare professionals examined the 28 joints used in the Disease Activity Score 28-joint count (DAS28). Then 7 sonographers examined each of the 7 patients twice, using previously published B-mode and PD grading systems. The clinical reference standard was presence of synovitis according to at least 4/7 examiners. The sonographic reference standard was at least grade 1 (ALG1) or 2 (ALG2) synovitis according to at least 4/7 sonographers. Interobserver reproducibility of sonography was assessed versus the sonographer having the best intraobserver reproducibility. Agreement was measured by Cohen’s kappa statistic.Results.Intraobserver and interobserver reproducibility of B-mode and PD used separately was fair to good. Agreement between clinicians and sonographers at all sites using B-mode, PD, and both was 0.46, 0.37, and 0.36, respectively, for grade 1 synovitis; and 0.58, 0.19, and 0.19 for grade 2 synovitis. The number of joints with synovitis was smaller by physical examination (36.7%) than by B-mode with ALG1 (58.6%; p < 0.001). The number of joints with synovitis was higher by physical examination than by PD with both ALG1 (17.8%; p < 0.0001) and ALG2 (6.6%; p < 0.0001).Conclusion.PD findings explain most of the difference between clinical and sonographic joint assessments for synovitis in patients with long-standing RA.

AB1039 Is Ultrasound the Mirror of Physical Examination? Association of Physical Examination Findings with Gray Scale and Power Doppler in Rheumatoid Arthritis

2015 ◽  
Vol 74 (Suppl 2) ◽  
pp. 1245.3-1246
Author(s):  
A.D. Do Prado ◽  
M.C. Bisi ◽  
D.M. Piovesan ◽  
M. Bredemeier ◽  
I.G. da Silveira ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Physical Examination ◽  
Power Doppler ◽  
Gray Scale

scholarly journals Clinical and ultrasound remission after 6 months of treat-to-target therapy in early rheumatoid arthritis: associations to future good radiographic and physical outcomes

2018 ◽  
Vol 77 (10) ◽  
pp. 1421-1425 ◽  
Author(s):  
Nina Paulshus Sundlisæter ◽  
Anna-Birgitte Aga ◽  
Inge Christoffer Olsen ◽  
Hilde Berner Hammer ◽  
Till Uhlig ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Disease Activity Score ◽  
Radiographic Progression ◽  
Activity Index ◽  
Power Doppler ◽  
Disease Activity Index ◽  
Treat To Target ◽  
Good Outcome ◽  
Grey Scale

ObjectiveTo explore associations between remission, based on clinical and ultrasound definitions, and future good radiographic and physical outcome in early rheumatoid arthritis (RA).MethodsNewly diagnosed patients with RA followed a treat-to-target strategy incorporating ultrasound information in the Aiming for Remission in rheumatoid arthritis: a randomised trial examining the benefit of ultrasound in a Clinical TIght Control regimen (ARCTIC) trial. We defined 6-month remission according to Disease Activity Score, Disease Activity Score in 28 joints-erythrocyte sedimentation rate, American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) Boolean criteria, Simplified Disease Activity Index, Clinical Disease Activity Index and two ultrasound definitions (no power Doppler signal, grey scale score ≤2). Two outcomes were defined: no radiographic progression and good outcome (no radiographic progression+physical function≥general population median), both sustained 12–24 months. We calculated the ORs of these outcomes for the remission definitions.ResultsOf 103 patients, 42%–82% reached remission at 6 months, dependent on definition. Seventy-one per cent of patients had no radiographic progression and 37% had good outcome. An association between 6-month remission and no radiographic progression was observed for ACR/EULAR Boolean remission (44 joints, OR 3.2, 95% CI 1.2 to 8.4), ultrasound power Doppler (OR 3.6, 95% CI 1.3 to 10.0) and grey scale remission (OR 3.2, 95% CI 1.2 to 8.0). All clinical, but not ultrasound remission criteria were associated with achievement of a good outcome.ConclusionsOur data support ACR/EULAR Boolean remission based on 44 joints as the preferred treatment target in early RA. Absence of ultrasound inflammation was associated with no radiographic progression.Trial registration numberNCT01205854; Post-results.

scholarly journals Use of Power Doppler Ultrasound in Haemophilia Could Predict Early Relapse of Intra Articular Bleeding after Haemarthrosis: A Prospective Cohort of 27 Haemarthrosis Monitored By Articular Ultrasound

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 1086-1086
Author(s):  
Laurent Frenzel ◽  
Stephanie Luzy ◽  
Cecile Lozach ◽  
Richard Delarue ◽  
Olivier Hermine ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Physical Examination ◽  
Synovial Membrane ◽  
Power Doppler ◽  
Doppler Signal ◽  
Joint Effusion ◽  
Clotting Factor ◽  
Joint Mobility ◽  
Early Relapse ◽  
Power Doppler Signal

Abstract Introduction: Whereas prophylactic treatment with clotting factor has demonstrated superiority to prevent joint disease versus on-demand therapy in haemophilia, haemophilic arthropathy remains an important complication of the disease. Repetitive intra articular bleeding are directly correlated to this progressive joint destruction. In rheumatoid arthritis, the use of articular Ultrasound with Power Doppler (USPD) has demonstrated superiority to predict joint inflammation and destruction over clinical examination and biological tests. Intensity of PD ultrasound is correlate to tissue vascularisation. As hypervascularization of synovial membrane would be probably associated to occurrence of intra articular bleeding, we proposed to evaluate PD ultrasound of synovial membrane in haemophilia. after a joint haemorrhage to predict haemarthrosis relapse. Method: Patients with severe haemophilia A(HA), B (HB) or type 3 von Willebrand (vWD) disease with acute haemarthrosis were prospectively included in a monocentric study, from April 2013 and November 2014. All included patients were treated using complementary daily clotting factor substitution according to clinical context. Clinical and USPD examination of the bleeding joint were performed at diagnosis (week 0: W0), week 1 (W1), week 2 (W2), month 1 (M1), month 2 (M2) and month 6 (M6). Physical examination considered pain, swelling and joint mobility. USPD was performed by the same radiologist, experienced in musculoskeletal ultrasound, using General Electric LogiqE9 device, with a high frequency (6-15 MHz) linear probe (PRF = 0,8 MHz), considering joint effusion, synovial thickening, presence of Power Doppler signal and bone erosion. Results : 21 patients were included: 16 children and 5 adults (median of age: 11,4 years-old). 14 patients presented HA, 3 HB and 4 vWD. 6 of them had inhibitors against clotting factor (4 with HA and 2 with vWD). All patients were on prophylactic regimen. 27 haemarthrosis were evaluated: 17 elbows, 7 knees and 3 ankles. 5 relapses were observed (median of time: 53 days). 3 of them had inhibitors (3/5). Clinically, all patients had no more pain at W2, even in case of relapse. At W2, swelling joint and joint mobility were identical to those before hemarthrosis. USPD showed: - 20/22 joints without Power Doppler signal did not rebleed, - all rebleeding joints presented Power Doppler signal (5/5), - in patients with no relapse, Power Doppler signal mainly disappeared between W2 (8/16) and M1 (11/16), - at M6, 8/12 patients presented abnormal USPD finding (6/12 joint effusion, 8/12 synovial thickening) without clinical evidence of relapse. Conclusion: As yet demonstrated in rheumatoid arthritis, USPD seems more sensitive than physical examination and very useful to manage haemarthrosis. Without PD signal, the risk of early relapse seems to be very low. Moreover the presence of PD signal seems to be correlated with higher risk of relapse. These findings would lead to better support patients with PD signal in order to avoid relapse, especially from W2 until PD signal disappeared. Persistent PD signal could justify an intensification of the treatment. Further studies should be conducted to confirm these data. Disclosures No relevant conflicts of interest to declare.

scholarly journals AB0158 COMPARISON OF CLINICAL EXAMINATION AND ULTRASOUND OF HAND AND WRIST JOINTS IN RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1106.1-1106
Author(s):  
S. Bouden ◽  
B. D. Siwar ◽  
A. Ben Tekaya ◽  
O. Saidane ◽  
R. Tekaya ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Clinical Examination ◽  
Disease Activity Score ◽  
Power Doppler ◽  
Doppler Signal ◽  
Left Wrist ◽  
The Mean ◽  
The Right ◽  
Power Doppler Signal

Background:Ultrasound (US) is an accessible and non-invasive tool to assess joint involvement in rheumatoid arthritis (RA). It is used for diagnostic and prognosis purposes and for following of RA patients by evaluating the disease activity and therefore the response to treatment.Objectives:This study investigates agreement between US of hand and wrist findings and the clinical examination and biological inflammatory parameters in RA patients.Methods:We performed a cross sectional study including patients responding to the ACR/EULAR 2010 criteria for RA diagnosis. We collected US findings assessing synovitis and doppler signal in wrist, metacarpophalangeal (MCP) and proximal interphalangeal (PIP) articulations, and concomitant clinical examination assessing synovitis and pain in the same joints along with C reactive protein (CRP) levels and disease activity score (DAS28). The power Doppler US score (PDUS) from 6 simplified synovial sites (wrists, bilateral second and third MCP joints) was calculated [1].Results:Forty-three patients were included with 91.7% of women. The mean age was 62±12.95 years old. The mean age at diagnosis was 52±14.79 years with a mean disease evolution of 8±8.57 years. Rheumatoid factor and anti-citrullinated antibodies were positive in respectively 78% and 83.9% of cases.The mean disease activity (DAS28) was 1,52 with levels ranging from 1.5 to 7.33.Right wrist was the articulation in which US synovitis was most frequently detected (60.5% of patients), followed by the left wrist (53.5%). Power doppler signal was detected as frequently in the right as in the left wrist articulations (41.9%). Subsequently, clinical synovitis was most frequently detected in right and left wrist with 39,5% and 41,5% respectively. These joints were the most frequently painful, in 51.2% and 48.8% at right and left respectively.US synovitis of the first interphalangeal joint was found in only 2.3% and 4.7% in the right and left hand respectively, with positive power doppler signal in 2.3% of the patients in the same articulations.The overall agreement between US and clinical examination in detecting synovitis of wrist, MCP and PIP joints was of 67.3%. It was of 71.4% in wrists, 54.7% in MCP joints and 87% in PIP joints. This suggests the presence of infra-clinical synovitis. All sites combined, US synovitis were correlated to clinical synovitis (p=0.03).A positive correlation was found between PDUS from 6 simplified joint sites and CRP levels (p value of 0.02). No correlation was found with disease activity score (DAS28).Conclusion:US of hands and wrist articulations is more performant than clinical examination in detecting synovitis. The most frequently involved joints with clinical and US synovitis, pain and positive power doppler signal were the wrist joints. CRP level is predictive of the presence of a high simplified power doppler score which is related to clinical activity of the disease as reported by Kawashiri et al. [1].References:[1]Kawashiri S, Kawakami A, Iwamoto N, Fujikawa K, Satoh K, Tamai M, et al. The power Doppler ultrasonography score from 24 synovial sites or 6 simplified synovial sites, including the metacarpophalangeal joints, reflects the clinical disease activity and level of serum biomarkers in patients with rheumatoid arthritis. Rheumatology (Oxford). mai 2011;50(5):962-5.Disclosure of Interests:None declared

Correlation of Radiographic Progression with the Cumulative Activity of Synovitis Estimated by Power Doppler Ultrasound in Rheumatoid Arthritis: Difference Between Patients Treated with Methotrexate and Those Treated with Biological Agents

2013 ◽  
Vol 40 (12) ◽  
pp. 1967-1976 ◽  
Author(s):  
Kei Ikeda ◽  
Daiki Nakagomi ◽  
Yoshie Sanayama ◽  
Mieko Yamagata ◽  
Ayako Okubo ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Radiographic Progression ◽  
Clinical Laboratory ◽  
Joint Destruction ◽  
Power Doppler ◽  
Joint Disease ◽  
Reactive Protein ◽  
Tnf Antagonists ◽  
The Difference ◽  
Modified Total Sharp Score

Objective.Our prospective study aimed to demonstrate that the cumulative synovial power Doppler (PD) ultrasound scores correlate with radiographic progression better than conventional measures in patients with rheumatoid arthritis (RA). We also investigated the difference between antirheumatic agents.Methods.Sixty-nine patients with RA who had recently received either methotrexate (MTX; n = 23), tumor necrosis factor (TNF) antagonists (n = 28), or tocilizumab (TCZ; n = 18) were enrolled. Patients underwent clinical, laboratory, and ultrasonographic assessment at baseline, 12 weeks, and 24 weeks. Radiographic damage was evaluated using van der Heijde modified total Sharp score (TSS) at baseline and 24 weeks.Results.Fifty-seven patients continued the same treatment regimen for 24 weeks and completed the study, and 21 patients (36.8%) showed radiographic progression during the study period. In all patients, ΔTSS significantly correlated both with cumulative 28-joint Disease Activity Score–C-reactive protein (DAS28-CRP; ρ = 0.342, p = 0.009) and cumulative total PD scores (ρ = 0.357, p = 0.006). In MTX-treated patients, cumulative total PD scores significantly correlated with ΔTSS (ρ = 0.679, p = 0.004), whereas cumulative DAS28-CRP did not (ρ = 0.487, p = 0.056). However, cumulative total PD scores did not correlate with ΔTSS in TNF antagonist–treated or TCZ-treated patients.Conclusion.Our data confirm the evidence that synovial PD activity more accurately reflects active synovial inflammation (which actually causes joint destruction) than do conventional measures in patients treated with MTX. Our data also indicate that TNF antagonists can inhibit short-term radiographic progression in the presence of active synovitis.

scholarly journals Biological tapering and sonographic flare in rheumatoid arthritis

2017 ◽  
Vol 66 (2) ◽  
pp. 325-328
Author(s):  
Chi-Hua Ko ◽  
Jia-Feng Chen ◽  
Tien-Tsai Cheng ◽  
Han-Ming Lai ◽  
Ying-Chou Chen
Keyword(s):  
Rheumatoid Arthritis ◽  
Body Mass Index ◽  
Body Mass ◽  
Antinuclear Antibodies ◽  
Disease Activity Score ◽  
Power Doppler ◽  
Joint Damage ◽  
Joint Disease ◽  
Logistical Regression Analysis ◽  
Necrosis Factor

This study aimed to evaluate the risk of ultrasound-detected synovitis after antitumor necrosis factor (TNF) tapering in patients with rheumatoid arthritis. We recruited patients with rheumatoid arthritis who accepted TNF tapering. Gray-scale synovitis and power Doppler score in bilateral wrists at the dorsal radiolunate joint were evaluated. We defined a sum of bilateral wrist scores of ≥2 as sonographic inflammation. Logistical regression analysis was used to adjust for confounding factors. One hundred and twenty-two patients who received a tapered dose of anti-TNF were enrolled, of whom 96 (78%) had ultrasound-detected synovitis and 26 had no inflammation. There were no significant differences in age, gender, body mass index, antinuclear antibodies, rheumatoid factor or anticitrullinated protein antibodies between the inflammation and non-inflammation groups. Moderate tapering of anti-TNF (tapering 50%) was more common in the patients with ultrasound-detected synovitis than mild tapering (tapering 25%) (68.8% vs 38.5%, p=0.005). After adjusting for age, body mass index, gender and a 28-joint Disease Activity Score, the moderate tapering group still had a higher risk of ultrasound-detected synovitis (OR 5.786, 95% CI 1.986 to 16.852; p=0.001); that is, the moderate tapering group had a 5.786 times higher risk of developing sonographic inflammation than the mild tapering group. The dose of biological tapering was the major determinant of ultrasound synovitis. Patients with moderate tapering had a higher risk of synovitis than those with mild tapering. We recommend not tapering by more than 25% to reduce subclinical inflammation and future joint damage.

scholarly journals Ankle involvement in rheumatoid arthritis – a comparison of inflammatory signs on musculoskeletal ultrasound and magnetic resonance imaging

2019 ◽  
Vol 21 (3) ◽  
pp. 265
Author(s):  
Luminita Enache ◽  
Claudiu Costinel Popescu ◽  
Mihaela Micu ◽  
Adriana Cojocaru ◽  
Victoria-Cristina Suta ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Sensitivity And Specificity ◽  
Power Doppler ◽  
Joint Involvement ◽  
Tibialis Posterior ◽  
Resonance Imaging ◽  
Inflammatory Lesions ◽  
Good Agreement

Aim: To evaluate the frequency of tibiotalar and subtalar joints together with extensor, flexor and peroneal tendons inflammatory lesions in rheumatoid arthritis (RA) patients by using ultrasound (US) and magnetic resonance imaging (MRI).Material and methods. Fifty RA patients and 25 healthy subjects were prospectively included. All patients and controlsunderwent clinical examination (to screen for swollen and/or tender ankles) and ankle US and MRI (to screen for synovialhypertrophy – SH, tenosynovitis and power Doppler – PD signals). The imaging tests were compared using overall agreement, positive agreement, Cohen’s κ, sensitivity, specificity and positive likelihood ratio.Results. The subtalar joint had the highest frequency of US-detected SH (30%), as well as positive PD signals (10%). Regarding US joint effusion, the tibiotalar joint recorded the highest frequency (44%). The most frequent US tenosynovitis was detected in the tibialis posterior tendon (40%). Compared to MRI, US evaluation of tibiotalar joints had very good agreement and large effect on detection probability for both SH and effusion (kappa 0.84, positive likelihood ratio 21.1). Compared to MRI, the sensitivity and specificity for US joint involvement ranged between 72.0-88.5% and 82.4-95.8%, and for tenosynovitis were 33.3-78.6% and 85.2-100%,  respectively. Compared to asymptomatic RA patients (n=25), those with at least one symptomatic ankle (n=25) had significantly higher frequencies of both SH and effusion in all the evaluated structures.Conclusion: US has high sensitivity and specificity in detecting RA inflammatory lesions in the ankle and rearfoot, in very good agreement with MRI. The high frequency of ankle inflammatory lesions in RA should result in increased interest in the imaging evaluation of these structures.

scholarly journals Ultrasound and multi-biomarker disease activity score for assessing and predicting clinical response to tofacitinib treatment in patients with rheumatoid arthritis

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Amir A. Razmjou ◽  
Jenny Brook ◽  
David Elashoff ◽  
Gurjit Kaeley ◽  
Soo Choi ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Clinical Response ◽  
Disease Activity Score ◽  
Activity Index ◽  
Power Doppler ◽  
Disease Activity Index ◽  
Response To Therapy ◽  
Activity Score ◽  
Linear Regression Models

Abstract Background Musculoskeletal ultrasound (MSUS) and the multi-biomarker disease activity (MBDA) score are outcome measures that may aid in the management of rheumatoid arthritis (RA) patients. This study evaluated tofacitinib response by MSUS/MBDA scores and assessed whether baseline MSUS/MBDA scores or their early changes predict later clinical response. Methods Twenty-five RA patients treated with tofacitinib were assessed at baseline, 2, 6 and 12-weeks. Power doppler (PDUS) and gray scale (GSUS) ultrasound scores, MBDA score, clinical disease activity index (CDAI), and disease activity score (DAS28) were obtained. Pearson correlations and multiple linear regression models were used to evaluate associations and identify predictors of response to therapy. Results MSUS, MBDA scores, CDAI, and DAS28 improved significantly over 12 weeks (p < 0.0001). Baseline MSUS and MBDA score correlated with each other, and with 12-week changes in CDAI/DAS28 (r = 0.45–0.62, p < 0.05), except for GSUS with DAS28. Two-week change in MSUS correlated significantly with 12-week changes in CDAI/DAS28 (r = 0.42–0.57, p < 0.05), except for early change in PDUS with 12-week change in CDAI. Regression analysis demonstrated significant independent associations between baseline PDUS/MBDA score and 6-week change in CDAI/DAS28, with adjustment for baseline CDAI/DAS28 (all p < 0.05); and between baseline MBDA scores and 12-week change in DAS28 (p = 0.03). Conclusions RA patients treated with tofacitinib for 12 weeks demonstrated improvement by clinical, imaging, and biomarker end-points. Baseline PDUS and MBDA score were predictive of CDAI and DAS28 responses. This is the first study to evaluate early measurements of MSUS and MBDA score as predictors of clinical response in RA patients treated with tofacitinib. Trial registration ClinicalTrials.gov NCT02321930 (registered 12/22/2014).

scholarly journals Comparison of the effects of forefoot jointpreserving arthroplasty and resectionreplacement arthroplasty on walking plantar pressure distribution and patient-based outcomes in patients with rheumatoid arthritis

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0021
Author(s):  
Kosuke Ebina ◽  
Hideki Tsuboi ◽  
Makoto Hirao ◽  
Takaaki Noguchi
Keyword(s):  
Rheumatoid Arthritis ◽  
Pressure Distribution ◽  
Plantar Pressure ◽  
Disease Activity Score ◽  
Metatarsal Head ◽  
Operative Duration ◽  
Plantar Pressure Distribution ◽  
Replacement Arthroplasty ◽  
Post Operation ◽  
The Difference

Category: Midfoot/Forefoot Introduction/Purpose: The purpose of this retrospective study is to clarify the difference in plantar pressure distribution during walking and related patient-based outcomes between forefoot joint-preserving arthroplasty and resection-replacement arthroplasty in patients with rheumatoid arthritis (RA). Methods: Four groups of patients were recruited. Group1 included 22 feet of 11 healthy controls (age 48.6 years), Group2 included 36 feet of 28 RA patients with deformed non-operated feet (age 64.8 years, Disease activity score assessing 28 joints with CRP [DAS28-CRP] 2.3), Group3 included 27 feet of 20 RA patients with metatarsal head resection-replacement arthroplasty (age 60.7 years, post-operative duration 5.6 years, DAS28-CRP 2.4), and Group4 included 34 feet of 29 RA patients with metatarsophalangeal (MTP) joint-preserving arthroplasty (age 64.6 years, post-operative duration 3.2 years, DAS28-CRP 2.3). Patients were cross-sectionally examined by F-SCAN II® to evaluate walking plantar pressure, and the self-administered foot evaluation questionnaire (SAFE-Q). Twenty joint-preserving arthroplasty feet were longitudinally examined at both pre- and post-operation. Results: In the 1st MTP joint, Group4 showed higher pressure distribution (13.7%) than Group2 (8.0%) and Group3 (6.7%) (P<0.001). In the 2nd-3 rd MTP joint, Group4 showed lower pressure distribution (9.0%) than Group2 (14.5%) (P<0.001) and Group3 (11.5%) (P<0.05). On longitudinal analysis, Group4 showed increased 1st MTP joint pressure (8.5% vs. 14.7%; P<0.001) and decreased 2nd-3 rd MTP joint pressure (15.2% vs. 10.7%; P<0.01) distribution. In the SAFE-Q subscale scores, Group4 showed higher scores than Group3 in pain and pain-related scores (84.1 vs. 71.7; P<0.01) and in shoe-related scores (62.5 vs. 43.1; P<0.01). Conclusion: Joint-preserving arthroplasty resulted in higher 1st MTP joint and lower 2nd-3 rd MTP joint pressures than resection-replacement arthroplasty, which were associated with better patient-based outcomes.

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