Abstract | OBJECTIVES: To examine whether MRI assessed inflammation and damage in the wrist of patients with early rheumatoid arthritis (RA) are associated with patient-reported outcomes (PROs). METHODS: Wrist and hand MRIs of 210 patients with early RA from two investigator-initiated, randomised controlled studies (CIMESTRA/OPERA) were assessed according to the Outcome Measures in Rheumatology RA MRI score (RAMRIS) for synovitis, tenosynovitis, osteitis, bone erosions and joint space narrowing (JSN) at baseline, 1 and 5 years follow-up. These features, and changes therein, were assessed for associations with health assessment questionnaires ( HAQ), patient global visual analogue scales (VAS-PtGlobal) and VAS- pain using Spearman's correlations, generalised estimating equations and univariate/multivariable linear regression analyses. MRI features were further tested for trends against specific hand-related HAQ items using Jonckheere trend tests. RESULTS: MRI inflammation, but not damage, showed statistically significant associations with HAQ, VAS-PtGlobal and VAS- pain for status and change scores, independently of C reactive protein and swollen joint count. MRI-assessed synovitis was most consistently associated with PROs, particularly VAS-PtGlobal and VAS- pain. MRI-assessed synovitis and tenosynovitis mean scores were positively associated with patient-reported difficulty to cut meat and open a milk carton (p<0.01), and similar patterns were seen for other hand-related HAQ items. Incorporating metacarpophalangeal joints in the analyses did not strengthen the associations between MRI pathology and PROs. CONCLUSIONS: MRI-assessed inflammation, but not damage, in early RA wrists is associated with patient-reported physical impairment, global assessment of disease activity and pain and influences the physical function in the hand. TRIAL REGISTRATION NUMBER: NCT00660647.
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Authors | Daniel Glinatsi, Joshua F Baker, Merete L Hetland, Kim Hørslev-Petersen, Bo J Ejbjerg, Kristian Stengaard-Pedersen, Peter Junker, Torkell Ellingsen, Hanne M Lindegaard, Ib Hansen, Tine Lottenburger, Jakob M Møller, Lykke Ørnbjerg, Aage Vestergaard, Anne Grethe Jurik, Henrik S Thomsen, Trine Torfing, Signe Møller-Bisgaard, Mette B Axelsen, Mikkel Østergaard |
Journal | Annals of the rheumatic diseases
(Ann Rheum Dis)
Vol. 76
Issue 10
Pg. 1707-1715
(Oct 2017)
ISSN: 1468-2060 [Electronic] England |
PMID | 28611080
(Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial)
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Copyright | © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. |
Chemical References |
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Topics |
- Adult
- Aged
- Arthritis, Rheumatoid
(blood, diagnostic imaging, drug therapy)
- C-Reactive Protein
(metabolism)
- Double-Blind Method
- Female
- Health Surveys
- Humans
- Inflammation
(blood, diagnostic imaging)
- Longitudinal Studies
- Magnetic Resonance Imaging
- Male
- Metacarpophalangeal Joint
(diagnostic imaging)
- Middle Aged
- Musculoskeletal Pain
(diagnostic imaging)
- Osteitis
(blood, diagnostic imaging)
- Pain Measurement
- Patient Reported Outcome Measures
- Radiography
- Severity of Illness Index
- Synovitis
(blood, diagnostic imaging)
- Tenosynovitis
(blood, diagnostic imaging)
- Wrist Joint
(diagnostic imaging)
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