case_images: PMC6652034_01
case_images: Joint ultrasonography findings. Left, before baricitinib administration; center, 24 weeks after the start of baricitinib administration; right, 52 weeks after the start of baricitinib administration. The abnormal findings in the following joints disappeared for up to 52 weeks in both PD and GS examinations: (a) left first MCP joint, (b) left second MCP joint, (c) left radial joint, and (d) left elbow joint (extensor surface/cross-sectional view). GS: grayscale; PD: power Doppler; MCP: metacarpophalangeal.
case_images: CRIRH2019-5293981.001.jpg
case_images: PMC6652034_01_CRIRH2019-5293981.001.jpg
case_images: fig1
case_images: In addition, improvements in the blood flow signal and synovial thickening were observed on joint ultrasonography 4 weeks after the introduction of baricitinib, and further improvements were observed at 24 and 52 weeks (Figures 1 and 2).
case_images: Changes in scores on joint ultrasonography (44 joints). A total of 44 joints were assessed with ultrasonography. The joint ultrasonography image shows significant improvement with time by baricitinib administration in the GS and PD examinations. Before introducing baricitinib: GS, 30 points, and PD, 23 points, with a total of 53 points. At 4 weeks after the introduction of baricitinib: GS, 23 points, and PD, 12 points, with a total of 35 points. At 24 weeks after the introduction of baricitinib: GS, 14 points, and PD, 7 points, with a total of 21 points. At 52 weeks after the introduction of baricitinib: GS, 1 point, and PD, 0 points, with a total of 1 point. Evaluation of the 44 joints included the DAS44 index (both sides of the hands, finger MCP joint, and IP/PIP, elbow, shoulder, sternoclavicular, acromioclavicular, knee, foot, and toe MTP joints). The severity grading of each joint in the GS and PD examinations was based on the classification by Szkudlarek et al.. The total scores for each joint were calculated for GS and PD. GS: grayscale; PD: power Doppler; MCP: metacarpophalangeal; MTP: metatarsophalangeal; DAS44: disease activity score 44; IP: interphalangeal; PIP: proximal interphalangeal.
case_images: CRIRH2019-5293981.002.jpg
case_images: PMC6652034_01_CRIRH2019-5293981.002.jpg
case_images: fig2
case_images: In addition, improvements in the blood flow signal and synovial thickening were observed on joint ultrasonography 4 weeks after the introduction of baricitinib, and further improvements were observed at 24 and 52 weeks (Figures 1 and 2).