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Subclinical synovitis detected by magnetic resonance imaging and ultrasonography following clinical remission in patients with rheumatoid arthritis: A retrospective study

Subclinical synovitis detected by magnetic resonance imaging and ultrasonography following clinical remission in patients with rheumatoid arthritis: A retrospective study

摘要Background::Subjective residual symptoms persist after clinical remission of rheumatoid arthritis (RA) in Japanese patients. Few studies have examined the relationship between these symptoms and subclinical inflammation using high-sensitivity imaging (musculoskeletal ultrasound [MSUS] and magnetic resonance imaging [MRI]). We examined the relationship between subjective residual symptoms and imaging findings in patients with RA who achieved clinical remission.Methods::We enrolled 30 patients with RA. The primary endpoint was the patients' subjective residual symptoms. The secondary endpoint was the relationship between the aforementioned symptoms and imaging findings.Results::Despite a mean Simplified Disease Activity Index of 1.3, imaging evaluation revealed inflammatory findings. In the multivariate analysis, the Health Assessment Questionnaire Disability Index (HAQ-DI) and pain visual analog scale (VAS) scores were extracted as independent related factors of subjective residual symptoms. The stratified analysis according to HAQ-DI showed a significant difference in synovitis on MRI between patients with and without residual disability (12.0 ± 8.7 vs. 5.3 ± 5.3, respectively; p = 0.0192). However, MSUS scores showed no significant difference in these two groups. In addition, no significant differences were found in MSUS and MRI scores between patients with and without residual pain VAS. Conclusions::Our findings demonstrated residual synovitis related to patient-reported outcomes in patients with RA who achieved clinical remission. In particular, patients with an HAQ-DI score of >0.25 even after achieving clinical remission should be further examined by MRI and/or MSUS for the evaluation of residual synovitis.

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作者 Nawata Masao [1] Someya Kazuki [1] Aritomi Takafumi [2] Funada Masashi [2] Nakamura Katsumi [3] Saito Kazuyoshi [1] Tanaka Yoshiya [2] 学术成果认领
作者单位 Department of Clinical Immunology and Rheumatology, Tobata General Hospital, Kitakyushu, Japan [1] The First Department of Internal Medicine, University of Occupational and Environmental Health Japan, Kitakyushu, Japan [2] Department of Radiology, Tobata General Hospital, Kitakyushu, Japan [3]
栏目名称 Original Article
DOI 10.1002/rai2.12006
发布时间 2025-02-25
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