High power Doppler ultrasound score is associated with the risk of triangular fibrocartilage complex (TFCC) tears in severe rheumatoid arthritis

In the distal radioulnar joint, the triangular fibrocartilage complex (TFCC) is an important stabilizer and are frequently found in patients with rheumatoid arthritis (RA) with wrist pain. This study was designed to predict TFCC tears using high-resolution ultrasound in severe RA. We retrospectively reviewed patients with severe RA. MRI and ultrasound were performed at baseline and after 1 year of follow-up. TFCC tears were recorded. The predictive factors for TFCC tears were analyzed by logistic regression. During the 1-year follow-up period, 54 patients were enrolled (42 females and 12 males), of whom 21 (38.9%) developed TFCC tears. The body mass index was 22.81±2.59 kg/m 2 in the TFCC tear group compared with 23.61±2.76 kg/m 2 in the non-tear group (p=0.136). The mean age was 55.14±9.54 years in the TFCC tear group compared with 56.45±14.04 years in the non-tear group (p=0.596). The tear group had a higher Disease Activity Score in 28 joints (DAS28) (6.36±0.47 vs 5.58±0.65, p=0.011) and higher power Doppler (PD) ultrasound score at the dorsal radiocarpal joint (1.90±1.30 vs 1.33±0.99, p=0.011) than the non-tear group. We found that high DAS28 (OR 2.96, 95% CI 1.95 to 4.50; p=0.001) and higher baseline PD score (OR 1.51, 95% CI 1.07 to 2.14; p=0.019) were significantly associated with a higher risk of TFCC tears by logistic regression. So we conclude a higher wrist PD score in severe RA predicted future TFCC tears. Therefore, we suggest to use PD score in such patients to monitor the risk of future TFCC tears.