THE RELATIONSHIP BETWEEN ULTRASONIC PARAMETERS OF HAND JOINTS AND LABORATORY MARKERS (RF, ANTI-CCP, CRP) IN RHEUMATOID ARTHRITIS

Relevance. Rheumatoid arthritis (RA) is accompanied by systemic immune inflammation, reflected by serological markers: rheumatoid factor (RF), antibodies to cyclic citrullinated peptide (anti-CCP), and C-reactive protein (CRP). Ultrasound examination (US) of hand joints provides objective morpho-functional data on synovitis, tenosynovitis and cartilage destruction. However, the quantitative relationship between laboratory markers and multimodal US parameters has not been systematically studied in the context of individual rehabilitation programs. Objective. To establish correlations between RF, anti-CCP, CRP and US parameters of hand joints in RA and to develop a laboratory-guided rehabilitation algorithm. Material and Methods. 142 patients with RA (ACR/EULAR 2010) divided into 3 serological groups. Ultrasound — B-mode, color Doppler imaging, compression elastography; 10 US parameters. Spearman correlation analysis; ROC analysis; multivariate linear regression. Results. The strongest correlations were found between CRP and synovitis GSS (r=0.83; p<0.001), PD index (r=0.79), and effusion volume (r=0.78). Anti-CCP correlated with GSS (r=0.74) more strongly than RF (r=0.71). The combined marker (RF+anti-CCP+CRP) provided the greatest predictive power for high ultrasound activity (AUC=0.94). A rehabilitation strategy guided by ultrasound and laboratory test data ensured remission in 44.1% of patients over 28 weeks. Conclusion. The integration of laboratory markers with multimodal ultrasound creates a reliable quantitative basis for personalizing rehabilitation programs for RA.

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