OP0205 ULTRASOUND-DETECTED CALCIUM PYROPHOSPHATE CRYSTAL DEPOSITION: WHICH SITES SHOULD BE SCANNED?

Background: In recent years, ultrasonography (US) has emerged as an accurate and reliable tool for the diagnosis of calcium pyrophosphate (CPP) deposition disease (CPPD) in daily practice. Previous studies analyzed diagnostic value US findings different tissues joints. However, no have investigated optimal scanning protocol CPPD at patient level. Objectives: To assess combinations OMERACT-defined upper lower limbs to select best minimal combination anatomic structures be scanned diagnosing inter-critical periods. Methods: Patients with a crystal-proven age- sex-matched disease-controls were prospectively enrolled this cross-sectional, monocentric, case-control study. All subjects underwent bilateral examination 9 hyaline cartilages (HC), 6 fibrocartilages (FC), 5 tendons, 1 joint recess ligament follows: shoulder (glenoid FC, humeral HC acromioclavicular FC), elbow (humeral triceps tendon), wrist (triangular scapho-lunate ligament, volar radio-lunate joint), hand (HC metacarpophalangeal joints from 2 nd th finger), hip (acetabular FC femoral HC), knee (femoral condyles’ HC, meniscal patellar quadriceps tendons), ankle (talar Achilles tendon plantar fascia). assessment was carried-out by rheumatologist blinded clinical data. CPP deposits identified presence/absence, according OMERACT definitions [1]. Results: Ninety-five patients enrolled: 45 (age: 72±10.6 duration: 5.6±7.8 female/male ratio: 1.3) 50 (18 rheumatoid arthritis, 13 osteoarthritis, 10 psoriatic arthritis gout). The medial lateral meniscus most frequently involved targets cases (81.8% 77.3% patients, respectively), followed triangular (68.2%), condyles (54.5%), (52.3%) acetabular (50.0%). all these anatomical targets, indicative detected significantly higher percentage than controls (p<0.01). protocols that showed balance between sensitivity specificity, sensitive specific shown Table 1. Diagnostic performances Anatomical SE SP LH+ LH - Knee 0.86 (0.76-0.96) (0.73-0.94) 6.35 (3.17-12.72) 0.13 (0.06-0.30) 0.93 (0.82-0.99) 0.82 (0.69-0.91) 5.19 (2.85-9.42) 0.08 (0.03-0.24) Hip 0.67 (0.51-0.80) 0.96 (0.86-0.99) 16.67 (4.22-65.82) 0.35 (0.23-0.53) : likelihood ratio, sensitivity, ultrasonography. protocols, each target assessed bilaterally. Figure includes representative pictures showing crystal targets. A: Wrist, longitudinal scan complex. B: Knee, meniscus. C: Hip, labrum D: condyle’s HC. Arrows: arrowhead: Conclusion: Our results suggest knee, provided acceptable specificity CPPD. References: [1]Filippou G, et al. Identification ultrasound: reliability extended set joints-an international multiobserver study Calcium Pyrophosphate Deposition Disease Ultrasound Subtask Force. Ann Rheum Dis. 2018;77:1194-9. Disclosure Interests: Edoardo Cipolletta: None declared, Jacopo Di Battista: Walter Grassi Speakers bureau: received speaking fees AbbVie, Celgene, Grünenthal, Pfizer Union Chimique Belge Pharma., Emilio Filippucci Filippucci. Bristol-Myers Squibb, Janssen-Cilag, Novartis, Pfizer, Roche Pharma.