SynthesisRheumatology (Oxford, England)2022
An ultrasound negative for subclinical synovitis in arthralgia patients: is it helpful in identifying those not developing arthritis?
Synthesis 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 7 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 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
- Observational
- Shorter reproductive time span and early menopause increase the risk of ACPA-negative inflammatory arthritis in postmenopausal women with clinically suspect arthralgia.Rheumatology (Oxford, England) · 2025Article
- 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
- Is rheumatoid arthritis always preceded by a symptomatic at-risk phase of arthralgia?RMD open · 2024Article
- Practical Use of Ultrasound in Modern Rheumatology-From A to Z.Life (Basel, Switzerland) · 2024Review
- Microwave Radiometry for the Diagnosis and Monitoring of Inflammatory Arthritis.Diagnostics (Basel, Switzerland) · 2023Review
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 3 countries.
Funding
Abstract
objectiveTo investigate the negative predictive value (NPV) of musculoskeletal US (MSUS) in arthralgia patients at risk for developing inflammatory arthritis.
methodsAn MSUS examination of hands and feet was performed in arthralgia patients at risk for inflammatory arthritis in four independent cohorts. Patients were followed for one-year on the development of inflammatory arthritis. Subclinical synovitis was defined as greyscale ≥2 and/or power Doppler ≥1. NPVs were determined and compared with the prior risks of not developing inflammatory arthritis. Outcomes were pooled using meta-analyses and meta-regression analyses. In sensitivity analyses, MSUS imaging of tender joints only (rather than the full US protocol) was analysed and ACPA stratification applied.
resultsAfter 1 year 78, 82, 77 and 72% of patients in the four cohorts did not develop inflammatory arthritis. The NPV of a negative US was 86, 85, 82 and 90%, respectively. The meta-analysis showed a pooled non-inflammatory arthritis prevalence of 79% (95% CI 75%, 83%) and a pooled NPV of 86% (95% CI 81, 89%). Imaging tender joints only (as generally done in clinical practice) and ACPA stratification showed similar results.
conclusionA negative US result in arthralgia has a high NPV for not developing inflammatory arthritis, which is mainly due to the high a priori risk of not developing inflammatory arthritis. The added value of a negative US (<10% increase) was limited.
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