Musculoskeletal ultrasound characteristics of checkpoint inhibitor-associated inflammatory arthritis
Authors' conclusion
Our data demonstrates its ability to expediate early identification of subclinical synovitis and/or tenosynovitis even when synovial fluid analysis is within the traditional non-inflammatory range.
Study context
- Population
- Patients ≥18 years who received immunotherapy with checkpoint inhibition (ICI) at the Mass General Cancer Center, 2010–2019, referred to rheumatology for musculoskeletal symptoms after ICI; suspected MSK immune-related adverse events (irAEs)34 definite de novo irAE
- Participants
- 55 patients
- Exposure
- Clinical synovitis vs No clinical synovitis
- Clinical synovitisn = 20
- No clinical synovitisn = 14
- Outcome
- MSKUS findings in definite de novo MSK irAE
Methodological detailssingle-centre, blinded US reader, musculoskeletal ultrasound (MSKUS) performed and interpreted by the same ultrasonographer; findings confirmed by a blinded US reader
- Single-centre
- Blinded US reader
- MSKUS performed and interpreted by the same ultrasonographer; findings confirmed by a blinded US reader
Main finding
As reported in the abstract
- Definite de novo irAE
- 34/55 (62 %)
- Alternative etiologies identified with diagnostic MSKUS
- 7
- Clinical synovitis: grade 2 or higher synovial thickening
- 80 %
- Clinical synovitis: hyperemia by color power Doppler (CPD) signal
- 70 %
- Clinical synovitis: tenosynovitis
- 60 %
- No clinical synovitis: inflammatory features identified
- 10 (71 %)
Observational data: associations, not effects.
Further findings
Synovial fluid analysis (n=15)
- Synovial fluid cell counts < 2000 cells/µL ('non-inflammatory' range)
- 7
- Of these, inflammatory MSKUS findings
- all 7
Original publication
Musculoskeletal ultrasound characteristics of checkpoint inhibitor-associated inflammatory arthritis. Semin Arthritis Rheum. Published 9 November 2024. doi:10.
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