Joint involvement in rheumatoid arthritis (RA) starts predominantly in the hands: functional, clinical and imaging studies in clinically suspect arthralgia and during progression to RA
Main finding · Severity of disabilities during course towards IA (HAQ, range 0-3)Result — go to the resultMean difference over time 0.41 units 95% CI 0.28–0.55Authors' conclusion
Evaluation of functional disabilities, supported by clinical and imaging findings, revealed that joint involvement starts predominantly in the hands during RA development.
Study context
- Population
- Patients with clinically suspect arthralgia (CSA) followed for clinical inflammatory arthritis (IA)99 developed IA
- Participants
- 600 patients
- Exposure
- Hand disabilities vs foot disabilities during progression from CSA to RA
- Outcome
- Course of hand vs foot functional disabilities (HAQ items) towards IA development
Methodological detailsfunctional, clinical and imaging studies, linear mixed models, Cox regression, Median follow-up 25 months; HAQ at baseline/4/12/24 months
- Functional, clinical and imaging studies
- Linear mixed models
- Cox regression
- Median follow-up 25 months; HAQ at baseline/4/12/24 months
Main finding
As reported in the abstract
Severity of disabilities during course towards IA (HAQ, range 0-3)
Mean difference over time
0.41 units
95% CI 0.28–0.55
P < 0.001
Hand disabilitiesvs Foot disabilities
mean difference over time 0.41 units (95% CI 0.28–0.55); P < 0.001
Observational data: associations, not effects.
Further findings
Single HAQ question on dressing difficulties at CSA presentation predicting IA development (total CSA population)
| HR (95% CI) | P value | ||
|---|---|---|---|
| Dressing difficultiesIndependently predictive | 2.2 (1.4–3.5) | P = 0.001 | |
| 0.20.5125Hazard ratio (log scale) |
Tender joints and subclinical joint inflammation (MRI)
- Occurred earlier in the hands than feet
Original publication
Joint involvement in RA starts predominantly in the hands: functional, clinical and imaging studies in clinically suspect arthralgia and during progression to RA. RMD Open. Published 16 June 2023. doi:10.
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