Comparison of findings on contrast-enhanced MRI of the hand, wrist, and forefoot in healthy controls, two at-risk groups, and patients with rheumatoid arthritis: a cohort study
Authors' conclusion
We describe several low-grade MRI-detected inflammatory findings of the hand, wrist, and forefoot that are less specific for rheumatoid arthritis.
Study context
- Population
- Participants from the Leiden Early Arthritis Clinic (EAC) and clinically suspect arthralgia (CSA) cohorts and healthy volunteers, Leiden University Medical Centre, Netherlands; mean age 51 years (SD 14)1,089 (68%) female
- Participants
- 1,612 participants
- Exposure
- Healthy controls and two at-risk groups vs patients with RA
- Healthy controlsn = 193reference
- Clinically suspect arthralgian = 598reference
- Undifferentiated arthritisn = 305reference
- Rheumatoid arthritisn = 516
- Outcome
- Frequency of MRI-detected synovitis, tenosynovitis and osteitis (RAMRIS) and intermetatarsal bursitis at MCP 2-5, wrist and MTP 1-5 joints; findings in >5% of a reference group considered less specific for RA
Methodological detailscontrast-enhanced MRI, two blinded independent readers, age-stratified comparisons
- Contrast-enhanced MRI
- Two blinded independent readers
- Age-stratified comparisons
Main finding
As reported in the abstract
MRI-detected inflammation in reference populations
- Grade 2 and 3 synovitis, tenosynovitis or osteitis did not occur in >5% of healthy controls and CSA non-converters (all ages)
- Grade 1 inflammation found at a number of hand, wrist and forefoot sites in >5% of all reference populations across all age groups; these locations also frequent in RA
- Frequency of inflammation across all cohorts increased with age
- Grade 2 inflammation in >5% only present in non-progressing UA aged ≥60 years
Observational data: associations, not effects.
Original publication
Comparison of findings on contrast-enhanced MRI of the hand, wrist, and forefoot in healthy controls, two at-risk groups, and patients with rheumatoid arthritis: a cohort study. Lancet Rheumatol. Published 13 June 2025. doi:10.
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