Subclinical inflammation on MRI of hand and foot of anticitrullinated peptide antibody-negative arthralgia patients at risk for rheumatoid arthritis

• Published in: Arthritis research & therapy 2014-04, Vol.16 (2), p.R92-R92, Article R92
• Main Authors: van Steenbergen, Hanna W, van Nies, Jessica A B, Huizinga, Tom W J, Reijnierse, Monique, van der Helm-van Mil, Annette H M
• Format: Article
• Language: English
• Subjects: Adult; Arthralgia - pathology; Arthritis, Rheumatoid - immunology; Arthritis, Rheumatoid - pathology; Autoantibodies - blood; Autoantigens - immunology; Disease Progression; Early Diagnosis; Female; Foot; Hand; Health aspects; Humans; Inflammation; Magnetic Resonance Imaging; Male; Medical research; Medicine, Experimental; Metacarpophalangeal Joint - pathology; Metatarsophalangeal Joint - pathology; Middle Aged; Risk Factors; Synovitis - pathology
• ISSN: 1478-6354; 1478-6362; 1478-6354
• DOI: 10.1186/ar4536

It is known that anticitrullinated peptide antibody (ACPA)-positive rheumatoid arthritis (RA) has a preclinical phase. Whether this phase is also present in ACPA-negative RA is unknown. To determine this, we studied ACPA-negative arthralgia patients who were considered prone to progress to RA for local subclinical inflammation observed on hand and foot magnetic resonance imaging (MRI) scans. We studied a total of 64 ACPA-negative patients without clinically detectable arthritis and with arthralgia of the small joints within the previous 1 year. Because of the character of the patients' symptoms, the rheumatologists considered these patients to be prone to progress to RA. For comparisons, we evaluated 19 healthy, symptom-free controls and 20 ACPA-negative RA patients, who were identified according to the 1987 American Rheumatism Association criteria. All participants underwent MRI of unilateral wrist, metacarpophalangeal and metatarsophalangeal joints. Synovitis and bone marrow oedema (BME) were scored according to the OMERACT rheumatoid arthritis magnetic resonance imaging scoring system, and the scores were summed to yield the 'MRI inflammation score'. Scores were compared between groups. Among the ACPA-negative arthralgia patients, MRI inflammation scores were related to C-reactive protein (CRP) levels and the tenderness of scanned joints. MRI inflammation scores increased progressively among the groups of controls and ACPA-negative arthralgia and RA patients (median scores = 0, 1 and 10, respectively; P