{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T20:28:31Z","timestamp":1773865711232,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T00:00:00Z","timestamp":1691366400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ACR Open Rheumatology"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate whether digital activity fluorescence optical imaging (FOI) patterns of inflammation can identify distinct rheumatoid arthritis (RA) phenotypes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The hands of newly diagnosed patients with RA were evaluated by clinical examination, musculoskeletal ultrasound, and FOI. Inflammation on FOI was defined when capillary leakage and\/or fluorophore perfusion was present. The FOI composite image was quantified into a digital disease activity (DACT) score, using novel computerized algorithms. Unsupervised clustering on FOI inflammatory patterns was used to identify subgroups of patients relative to anticyclic citrullinated peptides (ACPA) and\/or rheumatoid factor (RF).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 1326 examined hand joints in 39 patients with RA (72% female; 56% ever\u2010smokers; 54% RF positive and 69% ACPA positive), 400 (30%) showed inflammation by FOI, and 95% (37 of 39) of patients had DACT\u2010FOI scores greater than 1. Unsupervised analysis on FOI patterns revealed two patient clusters, cluster 1 (n\u00a0=\u00a029) and cluster 2 (n\u00a0=\u00a010). The proportion of seropositive patients was significantly higher in cluster 1 versus cluster 2 (90%, 26 of 29 vs. 30%, 3 of 10; <jats:italic>P<\/jats:italic> &lt;\u20090.01), whereas C\u2010reactive\u2010protein levels (minimum\u2010maximum) were significantly higher in cluster 2 (20 mg\/l [1\u2010102]) versus cluster 1 (2 mg\/l [0\u2010119]; <jats:italic>P<\/jats:italic> =\u20090.01). A wider variety and proportion of inflamed joints emerged for patients with RA in cluster 2 versus cluster 1, in which inflammation was more concentrated around the wrists and the right metacarpophalangeal 2 (MCP2), bilateral MCP3, and, to a lesser degree, left MCP2 and proximal interphalangeal joint and tendon regions. Cluster 1 displayed lower mean (\u00b1SD) DACT scores compared with cluster 2 (3.6 \u00b1\u20092.1 vs. 5.4 \u00b1\u20092.1; <jats:italic>P<\/jats:italic> =\u20090.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>FOI\u2010based digital quantification of hand joint inflammation revealed two distinct RA subpopulations with and without ACPA and RF related autoantibodies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr2.11599","type":"journal-article","created":{"date-parts":[[2023,8,8]],"date-time":"2023-08-08T02:14:30Z","timestamp":1691460870000},"page":"474-480","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Distinct Fluorescence Optical Imaging Patient Clusters Emerge for Seropositive and Seronegative Rheumatoid Arthritis"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3988-1629","authenticated-orcid":false,"given":"Yogan","family":"Kisten","sequence":"first","affiliation":[{"name":"Karolinska Institute and Karolinska University Hospital  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8077-8394","authenticated-orcid":false,"given":"Laurent","family":"Arnaud","sequence":"additional","affiliation":[{"name":"H\u00f4pitaux Universitaires de Strasbourg Service de Rhumatologie National Reference Center for Rare Systemic Autoimmune Diseases  Strasbourg Alsace\u2010Champagne\u2010Ardenne France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian","family":"Levitsky","sequence":"additional","affiliation":[{"name":"Karolinska Institute and Karolinska University Hospital  Stockholm 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Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik","family":"af Klint","sequence":"additional","affiliation":[{"name":"Karolinska Institute and Karolinska University Hospital  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hamed","family":"Rezaei","sequence":"additional","affiliation":[{"name":"Karolinska Institute and Karolinska University Hospital  Stockholm 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