Hand function is already reduced before rheumatoid arthritis (RA) development and reflects subclinical tenosynovitis
Authors' conclusion
Hand function is already often affected before RA development. These limitations are related to subclinical inflammation and tenosynovitis in particular.
Study context
- Population
- Patients with clinically suspect arthralgia (CSA), a risk stage for RAtwo CSA cohorts
- Participants
- 236 vs 600
- Exposure
- TREAT EARLIER vs Validation
- TREAT EARLIERn = 236
- Validationn = 600
- Outcome
- Hand function and its association with subclinical inflammation (MRI) in TREAT EARLIER
- Follow-up
- Baseline
Methodological detailstwo CSA populations, independent validation cohort, contrast-enhanced MRI of the hands
- Two CSA populations
- Independent validation cohort
- Contrast-enhanced MRI of the hands
Main finding
As reported in the abstract
baseline
- GS (dynamometer) reduced vs reference values in healthy controls
- 75%
- Reported grip difficulties
- 60%
- Incomplete fist closure
- 13%
- Reduced GS per point subclinical inflammation, kg/point
- −0.38 (95% CI −0.68 to −0.08)
- GS decrease per point tenosynovitis, kg (95% CI −2.26 to −0.33), independent association
- −2.63
- Patient-reported grip difficulties per point tenosynovitis, OR
- 1.12 (95% CI 1.07 to 1.42)
- Incomplete fist closure per point tenosynovitis, OR
- 1.36 (95% CI 1.03 to 1.79)
Observational data: associations, not effects.
Further findings
Hand function in validation cohort
- Decreased examiner-assessed GS
- 36%
- Reported grip difficulties
- 51%
- Incomplete fist closure
- 14%
- All associated with tenosynovitis
Detection of tenosynovitis
- Sensitivity, decreased dynamometer-measured GS (most sensitive)
- 75%
- Specificity, incomplete fist closure (most specific)
- 88%-90%
Original publication
Hand function is already reduced before RA development and reflects subclinical tenosynovitis. RMD Open. Published 9 February 2023. doi:10.
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