What is the etiologic role tenosynovitis in rheumatoid arthritis?

Updated: Aug 27, 2018
  • Author: Mark R Foster, MD, PhD, FACS; Chief Editor: Harris Gellman, MD  more...
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Answer

Eshed et al found that FT that is diagnosed by magnetic resonance imaging (MRI) is a strong predictor of early RA (sensitivity = 60%, specificity = 73%). The investigators also found that an even stronger predictor of RA is the combination of FT on MRI and a positive serum anti-cyclic citrullinated peptide or positive rheumatoid factor. [21]

Another study, by Navalho et al, indicated that MRI offers a better means than Doppler ultrasonography does of predicting the development of RA through the identification of tenosynovitis and carpal joint synovitis. The study involved 45 patients with untreated recent-onset polyarthritis. The hands and wrists of these patients were imaged using 3T MRI and Doppler ultrasonography, and 12 months later the patients were evaluated to determine whether or not their polyarthritis had progressed to fulfill the criteria for RA. [22]

The investigators found that 30 patients met the criteria for RA at follow-up and that 12 months earlier, 3T MRI had identified FT in 86.7% of these patients and also identified carpal joint synovitis in exactly the same percentage of this group. Doppler ultrasonography found FT and carpal joint synovitis in, respectively, 50% and 63.3% of the patients with RA. [22]

Using multivariate logistic regression analysis, the investigators found MRI identification of FT and carpal joint synovitis in early polyarthritis to be a powerful predictive tool in assessing a patient's chance of progressing to RA. [22]


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