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Validation of Babur's sign, a New Clinical Test for the Identification of Wrist Joint Synovitis in Rheumatoid Arthritis Patients

Salim B, Faisal MJ, Shahid M, Samreen S, Gul H, Nasim A, Afzal A

Introduction: The diagnosis of synovitis in Rheumatoid Arthritis (RA) can sometimes be very difficult without the use of advanced imaging techniques. A study was conducted to validate a new clinical test (Babur’s Sign), which we believed would help to detect synovitis in the wrist joint.

Objective: To Validate ‘Babur’s Sign’ on clinical examination in the Identification of Wrist Joint Synovitis in Rheumatoid Arthritis (RA) Patients presenting in a tertiary care hospital of Pakistan.

Methods: Using a sample size of 106 RA patients, consisting of 104 females and 2 males, musculoskeletal ultrasound examination as a control, and well-trained rheumatologists with experience in routine ultrasound examinations, a comparison was made between the test and Ultrasound findings. ‘Babur sign’ is when wrist hyperflexion performed by the clinician on the patient, results in immediate shoulder abduction along with elevation of the elbow in patients with active synovitis. First, Babur’s sign would be performed, after which the subject would have an ultrasound examination of the wrist joint done.

Results: We found Babur’s sign to have a sensitivity of 87.84% and a specificity of 78.13%. These findings support the potential application of Babur’s sign in regular clinical practice.

Conclusion: These findings support the potential application of Babur’s sign in regular clinical practice. Implementing this sign into routine examination, may save time for both the patient and doctor, expenses, with the benefit of being non-invasive and most importantly encourage early treatment thus yielding better prognostic outcomes for RA patients