Evidence map›Paper›PMID 37328293›Full record

ArticleRMD open2023

Joint involvement in RA starts predominantly in the hands: functional, clinical and imaging studies in clinically suspect arthralgia and during progression to RA.

Sarah J H Khidir, Bastiaan T van Dijk, Doortje I Krijbolder, Marloes Verstappen, Elise van Mulligen, Annette H M van der Helm-van Mil

Open access · goldAbstract read
PubMed Full text at PMC Publisher
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 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
3.0field-weighted citation impact, top 8% 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

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Observational
  3. Article
  4. Review
  5. Article
  6. Review
  7. Article
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

6 authors at 1 institution in 1 country.

Sarah J H KhidirDepartment of Rheumatology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands S.J.H.Khidir@lumc.nl.ORCID 0000-0001-5953-6844
Bastiaan T van DijkDepartment of Rheumatology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands.ORCID 0000-0002-5161-6791
Doortje I KrijbolderDepartment of Rheumatology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands.ORCID 0000-0003-1654-1031
Marloes VerstappenDepartment of Rheumatology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands.ORCID 0000-0002-7850-5063
Elise van Mulligen *Department of Rheumatology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands.ORCID 0000-0003-1900-790X
Annette H M van der Helm-van Mil *Department of Rheumatology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands.ORCID 0000-0001-8572-1437
Leiden University Medical Center · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesIt is unknown whether rheumatoid arthritis (RA) starts in hands or feet. To investigate this, we performed functional, clinical and imaging studies during progression from clinically suspect arthralgia (CSA) to RA. Additionally, we studied whether functional disabilities of hands/feet at CSA onset contribute to predicting RA development.

methods600 patients with CSA were followed for clinical inflammatory arthritis (IA) during median follow-up of 25 months, during which 99 developed IA. Functional disabilities were measured at baseline/4/12/24 months with the Health Assessment Questionnaire Disability Index (HAQ); HAQ items assessing hand disabilities and foot disabilities were selected. The course of disabilities towards IA development (here considered as t=0) was depicted by increasing incidences and analysed using linear mixed models. To evaluate robustness of findings, tender hand/foot joints and subclinical joint inflammation (measured with CE-1.5TMRI) of hand/foot were additionally studied. Associations between disabilities at CSA presentation (here t=0) and future IA development were studied using Cox regression in the total CSA population.

resultsDuring IA development, hand disabilities occurred earlier and more frequently than foot disabilities. Despite both hand disabilities and foot disabilities rose significantly towards IA development, hand disabilities were more severe during this course (mean difference over time: 0.41 units, 95% CI 0.28 to 0.55, p<0.001, on a range 0-3). Similar to functional disabilities, tender joints and subclinical joint inflammation occurred earlier in the hands than feet. In the total CSA population, a single HAQ question on difficulties with dressing (hand functioning) was independently predictive for IA development: HR=2.2, 95% CI 1.4 to 3.5, p=0.001.

conclusionEvaluation of functional disabilities, supported by clinical and imaging findings, revealed that joint involvement starts predominantly in the hands during RA development. Additionally, a single question on dressing difficulties adds value to risk stratification in patients with CSA.

Indexed as

Arthritis, RheumatoidMagnetic Resonance ImagingArthralgiaHandHumansInflammationAnti-Citrullinated Protein AntibodiesArthritis, RheumatoidMagnetic Resonance ImagingPatient Reported Outcome MeasuresRheumatoid Factor

Identifiers

PMID37328293
PMCPMC10277539
OpenAlexW4380986065

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.