Evidence map›Paper›PMID 41781162›Full record

ArticleRMD open2026

Modified Dixon MRI to detect subclinical inflammation in clinically suspect arthralgia as a risk factor for rheumatoid arthritis development: should we image one or two hands?

Daniek van der Kaaij, Stijn Claassen, Hanna W van Steenbergen, Edwin H G Oei, Pascal H P de Jong, Monique Reijnierse, Annette H M van der Helm-van Mil

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Article in RMD open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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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.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Daniek van der Kaaij *Department of Rheumatology, Erasmus Medical Center, Rotterdam, The Netherlands d.vanderkaaij@erasmusmc.nl.ORCID 0009-0002-6317-2339
Stijn Claassen *Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.ORCID 0009-0006-6299-7653
Hanna W van SteenbergenDepartment of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.ORCID 0000-0002-3251-0238
Edwin H G OeiDepartment of Radiology and Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.
Pascal H P de JongDepartment of Rheumatology, Erasmus Medical Center, Rotterdam, The Netherlands.ORCID 0000-0001-6628-6222
Monique ReijnierseDepartment of Radiology, Leiden University Medical Center, Leiden, The Netherlands.ORCID 0000-0002-6906-1851
Annette H M van der Helm-van MilDepartment of Rheumatology, Erasmus Medical Center, Rotterdam, The Netherlands.ORCID 0000-0001-8572-1437

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesMRI-detected subclinical inflammation in clinically suspect arthralgia (CSA) predicts progression to inflammatory arthritis (IA) and rheumatoid arthritis (RA) and is incorporated in EULAR/ACR risk stratification criteria. Conventional MRI is hampered by long scan times, intravenous contrast and high costs, while modified Dixon (mDixon) MRI, with 5 min scan time and no intravenous contrast, is much more feasible. To optimise mDixon MRI utility, we compared bilateral versus unilateral hand analysis for detecting subclinical inflammation. We also studied the distribution of subclinical inflammation in CSA.

methods139 patients of the CSA Leiden cohort were included. mDixon MRIs of bilateral wrist and metacarpophalangeal 2-5 joints were scored for subclinical inflammation (synovitis/tenosynovitis/osteitis) using RA MRI scoring. The hand with the most self-reported painful joints was used for unilateral analysis. Patients were followed for ≥6 months, with IA and RA development assessed at 6 months. We compared prognostic performance of bilateral versus unilateral MRI-detected subclinical inflammation.

resultsSubclinical inflammation detected on bilateral MRI was more strongly associated with IA development than on unilateral MRI; 4.80 (95% CI 1.09 to 21.11) versus 2.34 (95% CI 0.84 to 6.49). Bilateral analysis resulted in a 25% higher sensitivity and 15% lower specificity, with a net 10% increase in correctly classified patients. Results for RA development were similar, with HRs of 8.17 (95% CI 1.06 to 62.86) versus 3.23 (95% CI 0.98 to 10.66), and 20% higher sensitivity. Subclinical inflammation was unilateral in 52% of patients and scanning one hand would miss a quarter of patients.

conclusionBilateral MRI of the hands is preferable to unilateral MRI for detecting subclinical inflammation in CSA, because of its asymmetrical distribution.

Indexed as

ArthralgiaArthritis, RheumatoidHandInflammationMagnetic Resonance ImagingAdultAgedDisease ProgressionFemaleHumansMaleMetacarpophalangeal JointMiddle AgedPrognosisRisk FactorsArthritis, RheumatoidInflammationMagnetic Resonance ImagingRisk Factors

Identifiers

PMID41781162
PMCPMC12970117

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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.