ArticleRheumatology (Oxford, England)2022
Ultrasound subclinical synovitis in anti-CCP-positive at-risk individuals with musculoskeletal symptoms: an important and predictable stage in the rheumatoid arthritis continuum.
Article in Rheumatology (Oxford, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Imaging tests as predictors of progression to rheumatoid arthritis in clinically suspect arthralgia: a systematic review and meta-analysis.Rheumatology (Oxford, England) · 2025Pooled it
- Vision transformer-based ordinal model for semi-quantitative synovitis grading on musculoskeletal ultrasound: a retrospective study with internal and external validation.Annals of medicine · 2026Article
- Palindromic Rheumatism: Revisiting the Approach to an Enigmatic Condition.International journal of rheumatic diseases · 2026Article
- Observational
- A matter arising: When should inflammatory and autoimmune rheumatic diseases be considered 'early'?European journal of clinical investigation · 2026Review
- Beyond Conventional Imaging: Nuclear Imaging in Rheumatoid Arthritis.Journal of clinical medicine · 2025Review
- Ultrasound of the forefeet besides the hands in patients at risk for rheumatoid arthritis: is it worth the effort? A longitudinal cohort study.Rheumatology (Oxford, England) · 2025Article
- Biomarkers in the diagnosis, prognosis and management of rheumatoid arthritis: A comprehensive review.Annals of clinical biochemistry · 2025Review
- Practical Use of Ultrasound in Modern Rheumatology-From A to Z.Life (Basel, Switzerland) · 2024Review
- Prevention of Rheumatoid Arthritis in At-Risk Individuals: Current Status and Future Prospects.Drugs · 2024Review
- Ultrasound in anti-CCP+ at-risk individuals without clinical synovitis: development of a novel 6-joint protocol for feasible risk prediction.Rheumatology (Oxford, England) · 2024Article
- Article
- Added value of multiple autoantibody testing for predicting progression to inflammatory arthritis in at-risk individuals.RMD open · 2022Article
- The value of MRI for detecting subclinical joint inflammation in clinically suspect arthralgia.RMD open · 2022Review
- When and how should we use imaging in individuals at risk of rheumatoid arthritis?Frontiers in medicine · 2022Review
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
Abstract
objectivesTo investigate whether anti-CCP2-positive at-risk individuals with musculoskeletal (MSK) symptoms but without clinical synovitis (CCP2+ at-risk) develop US subclinical synovitis before inflammatory arthritis and if US subclinical synovitis can be predicted.
methodsFirst, US scans of CCP2+ at-risk individuals who developed inflammatory arthritis ('progressors') were reviewed for subclinical synovitis prior to inflammatory arthritis development. Patients in whom the pre-progression US scan was negative but the scan was conducted >6 months before progression were excluded. Subsequently, regression analyses were performed to identify predictors of US synovitis in CCP2+ at-risk individuals without baseline US abnormalities who had one or more longitudinal US scan and a complete dataset.
resultsUS subclinical synovitis was detected in one or more scan in 75 of 97 progressors (77.3%) {median time to inflammatory arthritis development from first evidence of US synovitis 26.5 weeks [interquartile range (IQR) 7-60]}, in whom one or more scan was available, excluding those with a negative scan >6 months from inflammatory arthritis development (n = 38). In 220 CCP2+ at-risk individuals with normal baseline US scans, who had one or more longitudinal US scan and a complete dataset, US synovitis was detected in 69/220 (31.4%) [median time to first developing US synovitis 56.4 weeks (IQR 33.0-112.0)]. In the multivariable analysis, only anti-CCP3 antibodies were predictive for the development of US synovitis [odds ratio 4.75 (95% CI 1.97, 11.46); P < 0.01].
conclusionsIn anti-CCP2+ at-risk individuals, a stage of subclinical synovitis usually precedes the development of inflammatory arthritis. Anti-CCP2+/CCP3+ individuals without clinical or US subclinical synovitis may represent the optimal window of opportunity for intervention to prevent joint disease.
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