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Kristian Stengaard-Pedersen

Magnetic resonance imaging assessed inflammation in the wrist is associated with patient-reported physical impairment, global assessment of disease activity and pain in early rheumatoid arthritis: longitudinal results from two randomised controlled trials

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  • Daniel Glinatsi, The DANBIO registry and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark.
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  • Joshua F Baker, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA.
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  • Merete L Hetland, g Department of Clinical Medicine, Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark., j Copenhagen Centre for Arthritis Research , Centre for Rheumatology and Spine Diseases, Rigshospitalet , Glostrup , Copenhagen , Denmark.
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  • Kim Hørslev-Petersen, b Institute of Regional Health Research , University of Southern Denmark , Odense , Denmark., King Christian 10th Hospital for Rheumatic Diseases, Gråsten, Denmark South Jutland Hospital and Institute of Regional Health Services Research, University of Southern Denmark, Odense, Denmark.
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  • Bo J Ejbjerg, b Department of Rheumatology , Slagelse Hospital , Slagelse , Denmark.
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  • Kristian Stengaard-Pedersen
  • Peter Junker, e Department of Rheumatology , Odense University Hospital , Odense , Denmark.
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  • Torkell Ellingsen, e Department of Rheumatology , Odense University Hospital , Odense , Denmark.
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  • Hanne M Lindegaard, e Department of Rheumatology , Odense University Hospital , Odense , Denmark.
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  • Ib Hansen
  • Tine Lottenburger, Department of Medicine, Rheumatology, Vejle Hospital, SLB, Vejle, Denmark.
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  • Jakob M Møller, Department of Radiology, Herlev Hospital, University of Copenhagen, Herlev, Denmark.
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  • Lykke Ørnbjerg, The DANBIO registry and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark.
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  • Aage Vestergaard, Department of Radiology, Hvidovre University Hospital, Hvidovre, Denmark.
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  • Anne Grethe Jurik
  • Henrik S Thomsen, g Department of Clinical Medicine, Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark., Department of Radiology, Herlev Hospital, University of Copenhagen, Herlev, Denmark.
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  • Trine Torfing, e Department of Rheumatology , Odense University Hospital , Odense , Denmark.
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  • Signe Møller-Bisgaard, The DANBIO registry and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark.
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  • Mette B Axelsen, The DANBIO registry and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark.
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  • Mikkel Østergaard, g Department of Clinical Medicine, Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark., Department of Rheumatology, Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark.

OBJECTIVES: To examine whether MRI assessed inflammation and damage in the wrist of patients with early rheumatoid arthritis (RA) are associated with patient-reported outcomes (PROs).

METHODS: Wrist and hand MRIs of 210 patients with early RA from two investigator-initiated, randomised controlled studies (CIMESTRA/OPERA) were assessed according to the Outcome Measures in Rheumatology RA MRI score (RAMRIS) for synovitis, tenosynovitis, osteitis, bone erosions and joint space narrowing (JSN) at baseline, 1 and 5 years follow-up. These features, and changes therein, were assessed for associations with health assessment questionnaires (HAQ), patient global visual analogue scales (VAS-PtGlobal) and VAS-pain using Spearman's correlations, generalised estimating equations and univariate/multivariable linear regression analyses. MRI features were further tested for trends against specific hand-related HAQ items using Jonckheere trend tests.

RESULTS: MRI inflammation, but not damage, showed statistically significant associations with HAQ, VAS-PtGlobal and VAS-pain for status and change scores, independently of C reactive protein and swollen joint count. MRI-assessed synovitis was most consistently associated with PROs, particularly VAS-PtGlobal and VAS-pain. MRI-assessed synovitis and tenosynovitis mean scores were positively associated with patient-reported difficulty to cut meat and open a milk carton (p<0.01), and similar patterns were seen for other hand-related HAQ items. Incorporating metacarpophalangeal joints in the analyses did not strengthen the associations between MRI pathology and PROs.

CONCLUSIONS: MRI-assessed inflammation, but not damage, in early RA wrists is associated with patient-reported physical impairment, global assessment of disease activity and pain and influences the physical function in the hand.

TRIAL REGISTRATION NUMBER: NCT00660647.

Original languageEnglish
JournalAnnals of the Rheumatic Diseases
Volume76
Issue10
Pages (from-to)1707-1715
Number of pages9
ISSN0003-4967
DOIs
Publication statusPublished - Oct 2017

    Research areas

  • Adult, Aged, Arthritis, Rheumatoid, C-Reactive Protein, Double-Blind Method, Female, Health Surveys, Humans, Inflammation, Longitudinal Studies, Magnetic Resonance Imaging, Male, Metacarpophalangeal Joint, Middle Aged, Musculoskeletal Pain, Osteitis, Pain Measurement, Patient Reported Outcome Measures, Radiography, Severity of Illness Index, Synovitis, Tenosynovitis, Wrist Joint, Journal Article, Multicenter Study, Randomized Controlled Trial

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