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Do magnetic resonance imaging-detected erosions predict progression to rheumatoid arthritis in patients presenting with clinically suspect arthralgia? A longitudinal study.
Scand J Rheumatol. 2020 Jun 02 [Online ahead of print]SJ

Abstract

OBJECTIVE

Radiographic joint erosions are a hallmark of rheumatoid arthritis (RA). Magnetic resonance imaging (MRI) is more sensitive than radiographs in detecting erosions. It is unknown whether MRI-detected erosions are predictive for RA development in patients with clinically suspect arthralgia (CSA). Therefore, we investigated the prognostic value of MRI-detected erosions, defined as any MRI erosion, or MRI erosion characteristics that were recently identified as specific for RA in patients with evident arthritis.

METHOD

Patients presenting with CSA (n = 490) underwent contrast-enhanced 1.5 T MRI of the wrist, metacarpophalangeal (MCP) and metatarsophalangeal (MTP) joints. MRIs were scored according to the Rheumatoid Arthritis Magnetic Resonance Imaging Scoring system (RAMRIS). Presence of any MRI erosion (present in < 5% of symptom-free controls) and RA-specific erosion characteristics as identified previously (grade ≥ 2 erosions, erosions in MTP5, erosions in MTP1 if aged < 40 years) were studied with clinically apparent inflammatory arthritis development as outcome. Analyses were corrected for age and MRI-detected subclinical inflammation.

RESULTS

Erosions were present in 20%. Presence of any MRI erosion was not associated with arthritis development [multivariable analysis hazard ratio (HR) 0.97 (95% confidence interval 0.59-1.59)]. The different RA-specific erosion characteristics were not predictive [grade ≥ 2 HR 1.05 (0.33-3.34), erosions in MTP5 HR 1.08 (0.47-2.48), and MTP1 if aged < 40 years HR 1.11 (0.26-4.70)]. Erosion scores were higher in anti-citrullinated protein antibody (ACPA)-positive than in ACPA-negative patients (median 2.0 vs 1.0, p = 0.002), and related to more subclinical inflammation. Within both subgroups, MRI erosions were not predictive.

CONCLUSIONS

MRI-detected erosions in hands and feet were not predictive for inflammatory arthritis development. Therefore, evaluating MRI for erosions in addition to subclinical inflammation does not provide added clinical value in CSA.

Authors+Show Affiliations

Department of Rheumatology, Leiden University Medical Centre , Leiden, The Netherlands.Department of Rheumatology, Leiden University Medical Centre , Leiden, The Netherlands.Department of Rheumatology, Leiden University Medical Centre , Leiden, The Netherlands.Department of Rheumatology, Leiden University Medical Centre , Leiden, The Netherlands.Department of Rheumatology, Leiden University Medical Centre , Leiden, The Netherlands. Department of Rheumatology, Erasmus University Medical Centre , Rotterdam, The Netherlands.Department of Rheumatology, Leiden University Medical Centre , Leiden, The Netherlands.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32484376

Citation

Wouters, F, et al. "Do Magnetic Resonance Imaging-detected Erosions Predict Progression to Rheumatoid Arthritis in Patients Presenting With Clinically Suspect Arthralgia? a Longitudinal Study." Scandinavian Journal of Rheumatology, 2020, pp. 1-7.
Wouters F, Matthijssen X, Boeters DM, et al. Do magnetic resonance imaging-detected erosions predict progression to rheumatoid arthritis in patients presenting with clinically suspect arthralgia? A longitudinal study. Scand J Rheumatol. 2020.
Wouters, F., Matthijssen, X., Boeters, D. M., Ten Brinck, R. M., Van Der Helm-Van Mil, A., & Niemantsverdriet, E. (2020). Do magnetic resonance imaging-detected erosions predict progression to rheumatoid arthritis in patients presenting with clinically suspect arthralgia? A longitudinal study. Scandinavian Journal of Rheumatology, 1-7. https://doi.org/10.1080/03009742.2020.1737221
Wouters F, et al. Do Magnetic Resonance Imaging-detected Erosions Predict Progression to Rheumatoid Arthritis in Patients Presenting With Clinically Suspect Arthralgia? a Longitudinal Study. Scand J Rheumatol. 2020 Jun 2;1-7. PubMed PMID: 32484376.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Do magnetic resonance imaging-detected erosions predict progression to rheumatoid arthritis in patients presenting with clinically suspect arthralgia? A longitudinal study. AU - Wouters,F, AU - Matthijssen,Xme, AU - Boeters,D M, AU - Ten Brinck,R M, AU - Van Der Helm-Van Mil,Ahm, AU - Niemantsverdriet,E, Y1 - 2020/06/02/ PY - 2020/6/3/entrez SP - 1 EP - 7 JF - Scandinavian journal of rheumatology JO - Scand. J. Rheumatol. N2 - OBJECTIVE: Radiographic joint erosions are a hallmark of rheumatoid arthritis (RA). Magnetic resonance imaging (MRI) is more sensitive than radiographs in detecting erosions. It is unknown whether MRI-detected erosions are predictive for RA development in patients with clinically suspect arthralgia (CSA). Therefore, we investigated the prognostic value of MRI-detected erosions, defined as any MRI erosion, or MRI erosion characteristics that were recently identified as specific for RA in patients with evident arthritis. METHOD: Patients presenting with CSA (n = 490) underwent contrast-enhanced 1.5 T MRI of the wrist, metacarpophalangeal (MCP) and metatarsophalangeal (MTP) joints. MRIs were scored according to the Rheumatoid Arthritis Magnetic Resonance Imaging Scoring system (RAMRIS). Presence of any MRI erosion (present in < 5% of symptom-free controls) and RA-specific erosion characteristics as identified previously (grade ≥ 2 erosions, erosions in MTP5, erosions in MTP1 if aged < 40 years) were studied with clinically apparent inflammatory arthritis development as outcome. Analyses were corrected for age and MRI-detected subclinical inflammation. RESULTS: Erosions were present in 20%. Presence of any MRI erosion was not associated with arthritis development [multivariable analysis hazard ratio (HR) 0.97 (95% confidence interval 0.59-1.59)]. The different RA-specific erosion characteristics were not predictive [grade ≥ 2 HR 1.05 (0.33-3.34), erosions in MTP5 HR 1.08 (0.47-2.48), and MTP1 if aged < 40 years HR 1.11 (0.26-4.70)]. Erosion scores were higher in anti-citrullinated protein antibody (ACPA)-positive than in ACPA-negative patients (median 2.0 vs 1.0, p = 0.002), and related to more subclinical inflammation. Within both subgroups, MRI erosions were not predictive. CONCLUSIONS: MRI-detected erosions in hands and feet were not predictive for inflammatory arthritis development. Therefore, evaluating MRI for erosions in addition to subclinical inflammation does not provide added clinical value in CSA. SN - 1502-7732 UR - https://www.unboundmedicine.com/medline/citation/32484376/Do_magnetic_resonance_imaging-detected_erosions_predict_progression_to_rheumatoid_arthritis_in_patients_presenting_with_clinically_suspect_arthralgia_A_longitudinal_study L2 - http://www.tandfonline.com/doi/full/10.1080/03009742.2020.1737221 DB - PRIME DP - Unbound Medicine ER -
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