Modified Dixon MRI to detect subclinical inflammation in clinically suspect arthralgia as a risk factor for rheumatoid arthritis development: should we image one or two hands?
Authors' conclusion
Bilateral MRI of the hands is preferable to unilateral MRI for detecting subclinical inflammation in CSA, because of its asymmetrical distribution.
Study context
- Population
- Patients with clinically suspect arthralgia (CSA), CSA Leiden cohortCSA Leiden cohort
- Participants
- 139 patients
- Comparison
- Bilateral vs unilateral (hand with most self-reported painful joints) modified Dixon (mDixon) MRI for detecting subclinical inflammation
- Outcome
- Prognostic performance of MRI-detected subclinical inflammation for IA development
- Follow-up
- 6 months
Methodological detailsCSA Leiden cohort, bilateral vs unilateral hand mDixon MRI, follow-up ≥6 months
- CSA Leiden cohort
- Bilateral vs unilateral hand mDixon MRI
- Follow-up ≥6 months
Performance
As reported in the abstract
Association of subclinical inflammation with IA development
Bilateral MRI
4.80
95% CI 1.09–21.11
Unilateral MRI
2.34
95% CI 0.84–6.49
- Bilateral analysis: higher sensitivity
- 25%
- Bilateral analysis: lower specificity
- 15%
- Bilateral analysis: net increase in correctly classified patients
- 10%
Further findings
Rheumatoid arthritis (RA) development: association with subclinical inflammation, bilateral vs unilateral MRI · 6 months
- HR, subclinical inflammation on bilateral MRI
- 8.17 (95% CI 1.06 to 62.86)
- HR, subclinical inflammation on unilateral MRI
- 3.23 (95% CI 0.98 to 10.66)
- Higher sensitivity with bilateral analysis
- 20%
- Results for RA development similar to inflammatory arthritis (IA)
Distribution of subclinical inflammation
- Subclinical inflammation unilateral, % of patients
- 52%
- Scanning one hand would miss a quarter of patients
Original publication
Modified Dixon MRI to detect subclinical inflammation in clinically suspect arthralgia as a risk factor for rheumatoid arthritis development: should we image one or two hands? RMD Open. Published 4 March 2026. doi:10.
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