Kaitlyn D’Onofrio

DocwireNews

A recent study analyzed&nbsp;the&nbsp;earliest inflammatory features in patients with clinically suspect arthralgia (CSA) who progress to rheumatoid arthritis (RA).&nbsp;Researchers evaluated 31 CSA patients&nbsp;(mean age, 44 years; 71% female) who&nbsp;progressed to RA with a 1.5-T MRI of the metacarpophalangeal (MCP), wrist, and metatarsophalangeal (MTP) joints at arthralgia onset and initial synovitis diagnosis. MRIs were used to identify osteitis, synovitis, tenosynovitis, and erosions; scores were compared to those of age-matched, symptomless patients.&nbsp;Compared to the age-matched, symptomless people,&nbsp;at presentation&nbsp;with arthralgia,&nbsp;CSA patients had higher synovitis&nbsp;scores&nbsp;(mean 2.2 vs. 0.93, p &lt; 0.001)&nbsp;and tenosynovitis scores&nbsp;(mean 1.7 vs. 0.27, p &lt; 0.001),&nbsp;but osteitis&nbsp;scores&nbsp;(1.9 vs. 1.4; p = 0.35) and erosion scores (1.7 vs. 1.8, p = 0.53) were not significantly higher.&nbsp;Average time between arthralgia presentation and progression to RA was 17 weeks; during progression, the mean osteitis score went from 1.9 to 2.7 (p = 0.036), and the mean synovitis score increased from 2.2 to 3.4 (p = 0.001), but there was no significant increase in&nbsp;mean&nbsp;tenosynovitis score (1.7 to 2.0, p = 0.35) or erosion score (1.7 to 1.9, p = 0.092).&nbsp;Researchers also evaluated differences between&nbsp;anti-citrullinated protein antibody&nbsp;(ACPA)-positive RA (n = 9) and ACPA-negative RA (n = 22) patients. When compared with the&nbsp;age-matched healthy controls, at arthralgia presentation, ACPA-positive patients had&nbsp;higher osteitis scores (p&thinsp;=&thinsp;0.04), synovitis scores (p&thinsp;&lt;&thinsp;0.001), and tenosynovitis scores (p&thinsp;&lt;&thinsp;0.001), but there was no difference in erosion scores. ACPA-negative RA patients had elevated&nbsp;synovitis scores (p&thinsp;=&thinsp;0.02) and tenosynovitis scores (p&thinsp;=&thinsp;0.001),&nbsp;but osteitis scores and erosion scores were not different.&nbsp;The researchers concluded, &ldquo;Our study demonstrated that synovitis and osteitis scores increased during progression from arthralgia to clinical arthritis, suggesting an &lsquo;outside-in&rsquo; temporal relationship of arthritis development, particularly in ACPA-negative RA. For ACPA-positive RA further studies are needed.&rdquo;&nbsp;<a href="https://proddocwire.wpengine.com/docwire-pick/palindromic-rheumatism-rheumatoid-arthritis/">Unique Imaging Sets Palindromic Rheumatism Apart from Rheumatoid Arthritis</a>&nbsp;<a href="https://proddocwire.wpengine.com/rheumatology/assessing-rheumatoid-arthritis-bone-damage-with-high-resolution-peripheral-quantitative-ct/">Assessing Rheumatoid Arthritis Bone Damage&nbsp;With&nbsp;High-Resolution Peripheral Quantitative CT</a>&nbsp;<a href="https://proddocwire.wpengine.com/abstracts/microsurgical-soft-tissue-reconstruction-in-lower-extremity-osteitis/">Microsurgical soft tissue reconstruction in lower extremity osteitis</a>&nbsp;<a href="https://proddocwire.wpengine.com/abstracts/injected-corticosteroid-type-dose/">The Effectiveness of Injected Corticosteroid Type, Dose, and Volume for the Treatment of Pain in Small- and Intermediate-size Joints: A Systematic Review</a>&nbsp;Source:&nbsp;<a href="https://arthritis-research.biomedcentral.com/articles/10.1186/s13075-018-1756-z">Arthritis Research &amp; Therapy</a>

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Study Assesses Joint Inflammation During RA Progression

Rheumatoid Arthritis

A recent study analyzed the earliest inflammatory features in patients with clinically suspect arthralgia (CSA) who progress to rheumatoid arthritis (RA). 
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