Evidence map›Paper›PMID 36759005›Full record

ArticleRMD open2023

Hand function is already reduced before RA development and reflects subclinical tenosynovitis.

Doortje Isabelle Krijbolder, Sarah J H Khidir, Xanthe M E Matthijssen, Robin M Ten Brinck, Jill van Aken, Irene Speyer, Florus J van der Giesen, Elise van Mulligen, Annette H M van der Helm-van Mil

Open access · goldAbstract read
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In one paragraph

Article in RMD open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
2.5field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 10 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Doortje Isabelle KrijbolderDepartment of Rheumatology, Leiden University Medical Center, Leiden, Netherlands d.i.krijbolder@lumc.nl.ORCID 0000-0003-1654-1031
Sarah J H KhidirDepartment of Rheumatology, Leiden University Medical Center, Leiden, Netherlands.ORCID 0000-0001-5953-6844
Xanthe M E MatthijssenDepartment of Rheumatology, Leiden University Medical Center, Leiden, Netherlands.ORCID 0000-0001-7332-8072
Robin M Ten BrinckDepartment of Rheumatology, Leiden University Medical Center, Leiden, Netherlands.
Jill van AkenDepartment of Rheumatology, Spaarne Gasthuis, Haarlem, Netherlands.
Irene SpeyerDepartment of Rheumatology, Haaglanden Medical Center, Westeinde The Hague, Netherlands.
Florus J van der GiesenDepartment of Rheumatology, Leiden University Medical Center, Leiden, Netherlands.ORCID 0000-0002-4261-7979
Elise van MulligenDepartment of Rheumatology, Leiden University Medical Center, Leiden, Netherlands.ORCID 0000-0003-1900-790X
Annette H M van der Helm-van MilDepartment of Rheumatology, Leiden University Medical Center, Leiden, Netherlands.ORCID 0000-0001-8572-1437
Leiden University Medical Center · NLMedisch Centrum Haaglanden · NLSpaarne Gasthuis · NL

Funding

European Research Council 714312
6 · The paper itself

Abstract

backgroundClinically suspect arthralgia (CSA) is characterised by arthralgia of small joints and considered a risk stage for development of rheumatoid arthritis (RA). However, it remains unknown if the function of the hands is already affected and what mechanisms underlie impaired hand-function in CSA.

methodsWe studied various measures of hand function in two CSA populations. CSA patients in the TREAT EARLIER-trial (n=236) were evaluated at baseline for: grip strength on a dynamometer (GS), patient-reported difficulties in the grip domain of the Health Assessment Questionnaire (HAQ) questionnaire and incomplete fist closure at physical examination. Findings were validated in an independent CSA cohort (n=600) where hand function was measured as: GS evaluated by squeezing the examiner's fingers, grip domain of the HAQ questionnaire and fist closure. Contrast-enhanced MRI of the hands measured synovitis, tenosynovitis and bone marrow oedema (summed as subclinical inflammation) in both cohorts.

resultsGS (on a dynamometer) was reduced in 75% compared with reference values in healthy controls, 60% reported grip difficulties and 13% had incomplete fist closure. Reduced GS was associated with subclinical inflammation (-0.38 kg/point inflammation, 95% CI -0.68 to -0.08). Studying separate MRI features, GS reduction was independently associated with tenosynovitis, decreasing with -2.63 kg (95% CI -2.26 to -0.33)/point tenosynovitis (range observed tenosynovitis scores: 0-20). Similar relations with tenosynovitis were seen for patient-reported grip difficulties (OR 1.12/point, 95% CI 1.07 to 1.42) and incomplete fist closure (OR 1.36/point, 95% CI 1.03 to 1.79). In the validation cohort, 36% had decreased examiner-assessed GS, 51% reported grip difficulties and 14% incomplete fist closure: all were associated with tenosynovitis. Decreased dynamometer-measured GS was most sensitive for detecting tenosynovitis (75%), while incomplete fist closure was most specific (88%-90%).

conclusionHand function is already often affected before RA development. These limitations are related to subclinical inflammation and tenosynovitis in particular.

Indexed as

Arthritis, RheumatoidTenosynovitisArthralgiaDisease ProgressionHumansInflammationArthritis, RheumatoidMagnetic Resonance ImagingPatient Reported Outcome MeasuresSynovitis

Identifiers

PMID36759005
PMCPMC9923344
OpenAlexW4319731070

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.