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Synovitis predicts subsequent structural progress in RA
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Synovitis predicts subsequent structural progression in patients with rheumatoid arthritis better than tenderness, according to study results.
Researchers performed a post hoc analysis on a prospective 2-year study of 59 patients with active rheumatoid arthritis (RA) starting on antitumor necrosis factor. Researchers assessed tenderness and synovitis clinically at baseline, followed by masked ultrasound assessment on hands and feet, and obtained radiographs of these joints at baseline and at 2 years.
When compared with synovitis, results showed baseline tender joints were the least predictive for radiographic progression. Researchers found tender joints with the presence of synovitis were predictive of radiographic progression of RA, especially seen in the metatarsophalangeal joints, whereas non-tender joints with no synovitis were negatively predictive. Radiographic progression was negatively predicted by persistence of tender joints but predicted by persistence of synovitis, according to results.
“We were able to systematically demonstrate that tender joints were inferior to synovitis — either derived by clinical swelling or ultrasound, to predict for subsequent damage at the joint level in patients with rheumatoid arthritis,” Peter Cheung, MBBS, PhD, FRACP, FAMS, senior consultant in the department of rheumatology at National University Hospital, Singapore, told Healio.com/Rheumatology. “This is important, as many measures in disease activity in the past placed more importance on tender joints than swollen joints, largely because we believed that swollen joints had poor reliability. However, when interpreted with swollen joints or synovitis, tender joints are useful and can improve its predictive value for subsequent radiographic damage.” – by Casey Tingle
Disclosure: Cheung reports no relevant financial disclosures.
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