MRI tenosynovitis, ultrasound erosions predict arthritis progression in at-risk patients

A prospective cohort study of 130 anti-CCP-positive individuals with musculoskeletal symptoms but no clinical synovitis used contrast-enhanced MRI and ultrasound to identify predictors of progression to inflammatory arthritis. Over a median follow-up of 36.5 months, 36.9% progressed to inflammatory arthritis; the study reported that MRI-detected hand tenosynovitis and ultrasound-detected bone erosions each independently predicted progression, and individuals with both features had the highest risk (hazard ratio 5.83). The authors state this supports complementary roles for MRI and ultrasound, while noting that feasibility and cost-effectiveness of combining both modalities require further evaluation.

Most relevant for: Anti-CCP-positive individuals with musculoskeletal symptoms but no clinical synovitis being evaluated for risk of progression to inflammatory arthritis.

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