The use of MRI-detected synovitis to determine the number of involved joints for the 2010 ACR/EULAR classification criteria for Rheumatoid Arthritis – is it of additional benefit?. Issue 8 (20th April 2018)

• Record Type: Journal Article
• Authors: Boer, Aleid C; Boeters, Debbie M; van der Helm-van Mil, Annette H M
• Is Part Of: Annals of the rheumatic diseases. Volume 77:Issue 8(2018)
• Page Start: 1125
• Page End: 1129
• Publication Date: 2018-04-20
• Subjects: rheumatoid arthritis -- early rheumatoid arthritis -- magnetic resonance imaging; Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-213143
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Objective: To assess the value of MRI-detected synovitis to determine the number of involved joints on the performance of the 2010-ACR/EULAR classification criteria for rheumatoid arthritis (RA). Methods: 277 patients with a clinical suspicion of RA consecutively included in the Leiden Early Arthritis Clinic (EAC)-cohort underwent 1.5T MRI of MCP-, wrist- and MTP-joints. Test characteristics of the 2010-criteria were calculated when the number of involved joints was determined with and without including MRI-detected synovitis. Two outcomes were studied: disease modifying anti-rheumatic drug (DMARD)-initiation and 1987-criteria fulfilment during the first year. Results: At baseline, 143 patients were classified as RA. When MRI-detected synovitis was considered, 14 patients additionally fulfilled the 2010-criteria. Of these, 64% (9/14) started DMARDs. When MRI-detected synovitis was also used to determine the number of involved joints the sensitivity changed from 62% to 67%, the specificity from 90% to 84% and the AUC from 0.76 to 0.75. The net reclassification index was −2.4%. When fulfilling the 1987-criteria was used as outcome, results were similar. Conclusion: We found no scientific support that the use of MRI-detected synovitis is of additional benefit for the performance of the 2010 classification criteria.