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Background <p>Sarcopenia, characterized by the loss of skeletal muscle mass and strength, is a significant complication in rheumatoid arthritis (RA), resulting in decreased functional capacity and greater disability. Early detection is crucial for effective intervention and improved patient management. Recent imaging advancements, specifically computed tomography (CT) and musculoskeletal ultrasound, show potential for early detection of sarcopenia in rheumatic diseases. However, their comparative diagnostic efficacy in RA patients has yet to be thoroughly established. This study aimed to evaluate the usefulness of ultrasound and CT in diagnosing sarcopenia in patients with rheumatoid arthritis, with findings compared to a healthy control group, and to assess the diagnostic performance of ultrasound relative to CT.</p> Results <p>RA patients showed significantly impaired functional performance, with reduced grip strength and chair stand test results (both <i>p</i> &lt; 0.001). CT and ultrasound revealed significant reductions in muscle mass and quality across multiple muscle groups in RA patients, including the quadriceps, psoas, abdominal, and paraspinal muscles (<i>p</i> &lt; 0.05). Ultrasound measurements of muscle thickness and cross-sectional area were significantly lower in RA patients and showed strong correlations with CT findings (r up to 0.756, <i>p</i> ≤ 0.001). ROC curve analysis demonstrated good diagnostic performance of ultrasound, with rectus femoris thickness showing the highest accuracy (Area under curve (AUC) = 0.853, sensitivity 73.3%, specificity 93.3%). Muscle parameters were significantly associated with functional test outcomes.</p> Conclusions <p>Rheumatoid arthritis is associated with significant skeletal muscle loss and functional impairment. Ultrasound shows strong agreement with CT and good diagnostic accuracy for detecting sarcopenia, particularly using Rectus Femoris (RF) thickness. These findings support ultrasound as a reliable, non-invasive alternative for sarcopenia assessment in RA patients when combined with functional evaluation.</p>

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Ultrasound and segmented computed tomography as diagnostic tools for sarcopenia in patients with rheumatoid arthritis: a case-control study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月6日

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  • Nour Mohamed Kandil,
  • Sahl Mahmoud Mohammed Ibraheem,
  • Noha Ahmad Mohamed Kamal Metaweh,
  • Hala Ramadan,
  • Aya Mohamed Bassam Hashem

摘要

Background

Sarcopenia, characterized by the loss of skeletal muscle mass and strength, is a significant complication in rheumatoid arthritis (RA), resulting in decreased functional capacity and greater disability. Early detection is crucial for effective intervention and improved patient management. Recent imaging advancements, specifically computed tomography (CT) and musculoskeletal ultrasound, show potential for early detection of sarcopenia in rheumatic diseases. However, their comparative diagnostic efficacy in RA patients has yet to be thoroughly established. This study aimed to evaluate the usefulness of ultrasound and CT in diagnosing sarcopenia in patients with rheumatoid arthritis, with findings compared to a healthy control group, and to assess the diagnostic performance of ultrasound relative to CT.

Results

RA patients showed significantly impaired functional performance, with reduced grip strength and chair stand test results (both p < 0.001). CT and ultrasound revealed significant reductions in muscle mass and quality across multiple muscle groups in RA patients, including the quadriceps, psoas, abdominal, and paraspinal muscles (p < 0.05). Ultrasound measurements of muscle thickness and cross-sectional area were significantly lower in RA patients and showed strong correlations with CT findings (r up to 0.756, p ≤ 0.001). ROC curve analysis demonstrated good diagnostic performance of ultrasound, with rectus femoris thickness showing the highest accuracy (Area under curve (AUC) = 0.853, sensitivity 73.3%, specificity 93.3%). Muscle parameters were significantly associated with functional test outcomes.

Conclusions

Rheumatoid arthritis is associated with significant skeletal muscle loss and functional impairment. Ultrasound shows strong agreement with CT and good diagnostic accuracy for detecting sarcopenia, particularly using Rectus Femoris (RF) thickness. These findings support ultrasound as a reliable, non-invasive alternative for sarcopenia assessment in RA patients when combined with functional evaluation.