Quantitative magnetic resonance imaging (MRI) tenosynovitis volume explains the association between tendon involvement and future development of clinical arthritis in anti-cyclic citrullinated peptide-positive at-risk individuals
Authors' conclusion
MRI-derived TSV independently predicts IA and outperforms SV.
Study context
- Population
- Anti-CCP-positive individuals with musculoskeletal symptoms without clinical synovitis, baseline contrast-enhanced MRI of hand and wrist
- Participants
- 223 individuals
- Exposure
- Progressors vs non-progressors to inflammatory arthritis; MRI tenosynovitis volume vs synovitis volume as predictors
- Progressorsn = 67
- Outcome
- Progression to IA (≥1 clinically swollen joint)
- Follow-up
- median 13.3-month follow-up
Methodological detailsquantitative MRI volumetric assessment, Cox regression, ROC analysis
- Quantitative MRI volumetric assessment
- Cox regression
- ROC analysis
Main finding
As reported in the abstract
Baseline TSV
P = 0.003
- Developed inflammatory arthritis (IA)
- 67 (30%)
- Tenosynovitis (TSV) remained predictive after adjusting for synovitis (SV)
- P = 0.008
- AUC for IA, TSV vs SV
- 0.697 vs 0.582
- TSV independently predicted progression in multivariable analysis
- P < 0.001
- Tender joint count independently predicted progression
- P = 0.014
Observational data: associations, not effects.
Further findings
Baseline tenosynovitis (34.5%) associated with progression
- Association with progression
- P < 0.001
Total inflammation volume and time to progression
- Higher volume correlated with shorter time to progression
- P = 0.008
Inter-reader agreement for volumetric scoring
- Intraclass correlation coefficient, all regions
- > 0.90
Original publication
Quantitative MRI tenosynovitis volume explains the association between tendon involvement and future development of clinical arthritis in anti-cyclic citrullinated peptide-positive at-risk individuals. Ann Rheum Dis. Published 10 March 2026. doi:10.
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