ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 309

Sub-Clinical Disease Activity in the Feet of Patients with Early Rheumatoid Arthritis: What Clinical Assessments Miss

Faiza Khokhar1, Hanyan Zou2, Myriam Allen1, Saara Totterman3, Karen A. Beattie4 and Maggie Larche5, 1Rheumatology, McMaster University, Hamilton, ON, Canada, 2McMaster University, Hamilton, ON, Canada, 3Qmetrics Technologies, Pittsford, NY, 4Medicine, McMaster University, Hamilton, ON, Canada, 5St Joseph's Healthcare Hamilton, Hamilton, ON, Canada

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: MRI, rheumatoid arthritis (RA) and ultrasound

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Date: Sunday, October 21, 2018

Title: Imaging of Rheumatic Diseases Poster I: MRI

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose:

Early diagnosis of RA and effective monitoring of disease activity are important for treatment decision-making. Early treatment strategies can be effective in preventing the development of erosive disease. The primary method of assessing disease activity with physical examination of swollen and tender joints has low accuracy and reliability but remains the cornerstone of assessment despite new imaging modalities. This study examines early RA disease activity in feet with clinical assessment and its correlation with findings on US and MRI, the latter being the reference standard.

Methods:

Treatment naive patients with early RA (ACR criteria, <2 years of symptom duration) were recruited. The most clinically symptomatic foot was assessed for swelling and tenderness in the metatarsophalangeal joints (MTPJ) 2-5. The same foot was imaged by US (Esaote MyLab70, 6-18 MHz linear array probe) and a peripheral MRI (1.0 Tesla, GE Medical). US images were semi-quantitatively graded for synovial thickening (0-3) and Power Doppler (PD) (0-3), representing hypervascularization by the rheumatologist who performed clinical assessments. Based on OMERACT RA MRI scoring criteria, a radiologist blinded to clinical and US results semi-quantitatively graded MTPJ 2-5 for bone marrow edema (BME) (grade 0-3 per metatarsal head and phalanx base, max=24) and synovitis (grade 0-3 per MTPJ, max=12).

Results:

Included in the analyses were 39 patients; 33 female (84.6%), mean (SD) symptom duration 12.2 months (10.9), 18 anti-CCP positive (46.2%), and15 RF positive (38.5%). Mean CRP and ESR levels were 18.9 mg/L (30.7) and 28.4 mm/hr (22.4), respectively. Of the 31 swollen MTP joints, 81% had synovial thickening on US, and of these joints, 44% showed PD and 64% had synovitis or BME grade ≥2 on MRI. Of 125 MTP joints assessed as not swollen, 41% (51 joints) were found to have synovial thickening on US with 22% also showing PD and 38% with synovitis or BME grade ≥2. Of the 39 patients, 18 had ≥1 swollen joint and, of this subset, 94% had synovial thickening, with 41% showing PD and 57% having synovitis or BME grade ≥2. Of the 21 patients without swelling, 86% (18 patients) had synovial thickening in ≥1 joint, with 28% showing PD and 40% having synovitis or BME grade ≥2.

Conclusion:

In examining patients with early RA, joints with synovial thickening and PD on US are also found to have inflammation on MRI. Making treatment decisions based solely on clinical presentation might result in under treatment of a fairly high proportion of patients with sub-clinical inflammation. These findings are suggestive that US with evidence of synovial thickening and PD may be helpful as an adjunct to clinical examination in assessing disease activity.


Disclosure: F. Khokhar, None; H. Zou, None; M. Allen, None; S. Totterman, None; K. A. Beattie, None; M. Larche, AbbVie Inc., 2.

To cite this abstract in AMA style:

Khokhar F, Zou H, Allen M, Totterman S, Beattie KA, Larche M. Sub-Clinical Disease Activity in the Feet of Patients with Early Rheumatoid Arthritis: What Clinical Assessments Miss [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/sub-clinical-disease-activity-in-the-feet-of-patients-with-early-rheumatoid-arthritis-what-clinical-assessments-miss/. Accessed .
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/sub-clinical-disease-activity-in-the-feet-of-patients-with-early-rheumatoid-arthritis-what-clinical-assessments-miss/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology