Ultrasound Measurement of Femoral Cartilage Thickness in Patients with Familial Mediterranean Fever and its Relation to Amyloidosis and Other Disease Characteristics

Objectives: This study aimed to determine femoral cartilage thickness (FCT) in patients with familial Mediterranean fever (FMF) and healthy individuals and to assess the relationship of FCT with the development of amyloidosis and clinical features.
Methods: Patients diagnosed with FMF according to the Tel-Hashomer criteria and healthy controls were included in the study. FCT of both knees was measured with a 7–12 MHz linear probe in maximum knee flexion. Three midpoint measurements were obtained from each knee: Lateral femoral condyle (LFC), intercondylar area (ICA), and medial femoral condyle (MFC). The patients’ clinic characteristics include disease duration, medications, comorbid conditions, amyloidosis, chronic renal failure (CRF), FMF gene mutation, arthritis, sacroiliitis, PRAS score, and Physical Activity Questionnaire Short Form score were recorded.
Results: A total of 46 patients with FMF (36 women) and 20 age-sex-body mass index-matched controls (14 women) were enrolled in this study. The patients and controls’ mean age were 37±12.9 and 37.5±8.6 years, respectively. Amyloidosis occurred in 7 patients (15.2%), CRF in 3 (6.5%), and knee arthritis in 8 (17%). Disease activity was mild in 55.8%, moderate in 20.9%, and severe in 23.23% of the patients. The mean FCT in millimeter values in the FMF and control groups was as follows: On the right side, LFC 1.9±0.5 and 2±0.52, ICA 2.2±0.77 and 2.25±0.97, and MFC 2±0.47 and 2.25±0.72; on the left side, LFC 1.9±0.4 and 2.05±0.55, ICA 2.25±0.87 and 2.25±0.87, and MFC 1.85±0.5 and 2.25±0.6. Patients with FMF had decreased cartilage thickness at the lateral condyle of both knees (p<0.05) and medial condyle of the left knee (p<0.05) compared with controls. FCT measurements were similar in patients with or without arthritis, amyloidosis, and CRF (p>0.05). FCT scores were not different among the disease activity groups (p>0.05).
Conclusion: These findings suggest that patients with FMF have decreased FCT compared with controls, and there is no significant relationship between the FCT and amyloidosis and disease activity.

Ailesel Akdeniz ateþi tanýlý hastalarda ultrasonografik femoral kartilaj kalýnlýðý ölçümü ve amioidoz ile diðer hastalýk özellikleri ile iliþkisi

AMAÇ: Bu çalýþmada, ailesel Akdeniz ateþi (AAA) olan hastalarda ve saðlýklý bireylerde femoral kartilaj kalýnlýðýnýn (FKK) ölçülmesi ve FKK ile amiloidoz geliþimi ve klinik özellikler ile iliþkisinin deðerlendirilmesi amaçlanmýþtýr.
METOD: Çalýþmaya Tel-Hashomer kriterlerine göre AAA tanýsý konan hastalar ve saðlýklý kontroller dahil edildi. Her iki dizde femoral kartilaj kalýnlýðý maksimum diz fleksiyonunda 7-12 MHz lineer prob ile ölçüldü. Her iki dizden üç noktadan ölçüm alýndý: lateral femoral kondil (LFK), interkondiler alan (ICA) ve medial femoral kondil (MFK). Hastalarýn klinik özelliklerinden hastalýk süresi, ilaçlar, komorbid durumlar, amiloidoz, kronik böbrek yetmezliði (KBY), FMF gen mutasyonu, artrit, sakroiliit, PRAS skoru ve Fiziksel Aktivite Anketi Kýsa Form (IPAQ-SF) skoru kaydedildi.
BULGULAR: Çalýþmaya 46 AAA (36 kadýn) ve 20 yaþ-cinsiyet-BMI uyumlu kontrol (14 kadýn) dahil edildi. Hastalarýn ve kontrollerin yaþ ortalamalarý sýrasýyla 37 ±12.9 ve 37.5 ±8.6 yýldý. Yedi hastada (%15.2) amiloidoz, 3 hastada (%6.5) KBY ve 8 hastada (%17) diz artriti meydana geldi. Hastalýk aktivitesi %55.8'inde hafif, %20.9'unda orta ve %23.23'ünde þiddetliydi. AAA ve kontrol gruplarýnda milimetre cinsinden ortalama FKK deðerleri þu þekildeydi: saðda LFK 1,9±0,5 ve 2±0,52, ICA 2,2±0,77 ve 2,25±0,97, MFK 2±0,47 ve 2,25±0,72; sol tarafta LFK 1,9±0,4 ve 2,05±0,55, ICA 2,25±0,87 ve 2,25±0,87, MFK 1,85±0,5 ve 2,25±0,6. AAA'li hastalarda kontrollere kýyasla her iki diz LFK (p<0.05) ve sol MFK (p<0.05) kýkýrdak kalýnlýðý azalmýþtý. Artrit, amiloidoz ve KBY olan ve olmayan hastalarda FCT ölçümleri benzerdi (p>0.05). FKK skorlarý hastalýk aktivite gruplarý arasýnda farklý deðildi (p>0.05).
SONUÇ: AAA hastalarýnda kontrollere kýyasla FKK azalmýþtýr ve FKK ile amiloidoz ve hastalýk aktivitesi arasýnda anlamlý bir iliþki yoktur. (SETB-2021-12-369)