[NMR paper] MRI of hand and foot joints of patients with anticitrullinated peptide antibody positive arthralgia without clinical arthritis.

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MRI of hand and foot joints of patients with anticitrullinated peptide antibody positive arthralgia without clinical arthritis.

Related Articles MRI of hand and foot joints of patients with anticitrullinated peptide antibody positive arthralgia without clinical arthritis.

Ann Rheum Dis. 2013 Jan 19;

Authors: Krabben A, Stomp W, van der Heijde DM, van Nies JA, Bloem HL, Huizinga TW, Reijnierse M, van der Helm-van Mil AH


Abstract
BACKGROUND: Anticitrullinated peptide antibodies (ACPA) and acute phase reactants may be increased before arthritis becomes clinically detectable, suggesting that the processes underlying rheumatoid arthritis (RA) start preclinically. Whether local inflammation occurs in the preclinical phase is unknown. Therefore, we studied the small joints of ACPA positive arthralgia patients for local subclinical inflammation. METHODS: Imaging was performed using 1.5 T extremity MRI. Painful hand or foot joints of 21 ACPA positive arthralgia patients without clinical arthritis were imaged. For comparison, hand and foot joints of 22 ACPA positive RA patients and 19 symptom free controls were studied. Within ACPA positive arthralgia patients, painful and symptom free joint regions were imaged. Scoring was performed according to the Outcome Measures in Rheumatology Clinical Trials (OMERACT) Rheumatoid Arthritis Magnetic Resonance Imaging Scoring (RAMRIS) method. Analyses were performed on joint region level and focused on inflammation (synovitis plus bone marrow oedema). RESULTS: The mean combined inflammation scores of the metacarpophalangeal/proximal interphalangeal joints of controls, painful joints of ACPA positive arthralgia patients and ACPA positive RA patients were 0.1, 0.7 and 3.7, respectively (p