Abstract
Introduction/objectives
First-degree relatives (FDR) of patients with rheumatoid arthritis (RA) are at increased risk of RA diagnosis. Magnetic resonance imaging (MRI) has been proposed as a useful tool to detect subclinical synovitis and bone abnormalities as predictors of progression to RA. The presence of grade ≥ 2 bone erosions in RA MRI scoring system (RAMRIS) was reported to be RA-specific. We aim to describe the prevalence and characteristics of MRI findings in RA patients and FDR.
Methods
A cross-sectional and exploratory study of 60 individuals was performed in 38 RA patients and 22 FDR with hand arthralgia without clinical arthritis and positive rheumatoid factor or anticitrullinated protein antibodies. All patients underwent an MRI and were evaluated for synovitis, bone erosion, and bone marrow edema. We evaluated second to fifth metacarpophalangeal joints of the dominant hand according to RAMRIS.
Results
Among the total population, eighteen (30%) subjects had grade ≥ 2 bone erosions, and 42 (70%) had at least one erosion of any grade. In patients with grade ≥ 2 bone erosions, 12 (31.6%) were from RA patients and 6 (27.2%) from FDR (p = 0.72). In patients with erosions of any grade, 26 (68.4%) were from RA patients and 15 (68.2%) were from FDR (p = 0.98).
Conclusion
A high prevalence of bone erosions was found in RA patients’ FDR who had symptoms without clinical arthritis and positive serology. MRI might be helpful in this population for an early detection of RA-specific erosions. The prognosis and the treatment decisions in these subjects should be elucidated.
Key points: • First-degree relatives (FDR) of rheumatoid arthritis (RA) patients with positive serology and joint symptoms constitute a select subpopulation of individuals with an increased risk of developing RA. • Magnetic resonance imaging (MRI) of FDR shows a high prevalence of bone erosions of any grade, grade ≥ 2 erosions, and synovitis. • MRI might be helpful in FDR of RA patients to screen for the presence of RA-specific erosions or clinically undetectable synovitis. |
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Funding
The project received funding from Dirección General de Planeación y Proyectos Estratégicos en el Programa para el Desarrollo Profesional Docente para el Tipo Superior (PRODEP) and Universidad Autónoma de Nuevo León. Cuerpos Académicos (CA) number 136.
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David Vega-Morales contributed to the study conception and design. Recruitment was performed by David Vega-Morales, Jorge Antonio Esquivel-Valerio, Mario Alberto Garza-Elizondo, Dionicio Ángel Galarza-Delgado, María del Carmen Larios-Forte, Lorena Pérez-Barbosa, Cassandra Michelle Skinner-Taylor, Brenda Roxana Vázquez-Fuentes, Diana Elsa Flores-Alvarado, Miguel Ángel Villarreal-Alarcón, Iván de Jesús Hernández- Galarza, Luis Iván lozano-Plata, Martha Mariana Castañeda-Martínez, Diana Daniela Castañeda-Martínez, Pablo Herrera-Sandate, and Jesús Alberto Cárdenas-de la Garza. Analysis and interpretations were performed by David Vega Morales. Writing of the first draft was performed by David Vega-Morales and Jorge Antonio Esquivel-Valerio. Writing of the following drafts was performed by Pablo Herrera-Sandate and Jesús Alberto Cárdenas-de la Garza. All authors commented on the following versions of the manuscript. All authors read and approved the final manuscript.
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This study was approved by the institutional research and ethics committee of the University Hospital “Dr. Jose E. González” from the Universidad Autónoma de Nuevo León, with registration number RE-17–000-10 and was therefore conducted in accordance with the ethical standards set forth in the Declaration of Helsinki and its subsequent amendments.
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Vega-Morales, D., del Carmen Larios-Forte, M., Pérez-Barbosa, L. et al. Bone erosions by MRI in first-degree relatives of patients with RA: an exploratory study. Clin Rheumatol 41, 1343–1348 (2022). https://doi.org/10.1007/s10067-021-06028-4
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DOI: https://doi.org/10.1007/s10067-021-06028-4