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The aim of this study was to characterize RP, its perception, and patient-dependent features and to evaluate its possible association with residual synovitis in patients with RA in remission.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Ninety-seven patients with RA, including 68 in sustained clinical and ultrasound remission (Rem\/RA) and 29 in high\/moderate DAS28-CRP disease activity (H-Mo\/RA) were enrolled in the study. Thirty patients with fibromyalgia were enrolled as a control group(FIBRO). At study entry, demographic, clinical, ultrasound characteristics, and pain dimension assessment (VAS-pain, FACIT, CSI, GHQ, and RAID) were collected for each patient. RA patients underwent synovial tissue biopsy to evaluate the degree of synovitis using the Krenn synovitis score (KSS).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Forty-eight percent of Rem\/RA still declared unacceptable pain (VAS-Pain\u2009&gt;\u200920) compared to 80% of H-Mo\/RA patients (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). Furthermore, Rem\/RA patients presented comparable levels of pain dimension assessment regardless of KSS. However, classifying Rem\/RA group based on RAID score (&lt;\u20092 as satisfied SAT-Rem\/RA and\u2009\u2265\u20092 as unsatisfied UNSAT-Rem\/RA), SAT-Rem\/RA group presented a lower grade of VAS-Pain (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), lower percentage of patients with an unacceptable pain (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) and lower grade of fatigue(<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) compared to the UNSAT-Rem\/RA patients. The percentage of SAT-Rem\/RA patients who presented a disease flare did not differ from UNSAT-Rem\/RA over the 24\u00a0months of follow-up. Finally, female Rem\/RA patients presented higher VAS-Pain compared to male Rem\/RA (<jats:italic>p<\/jats:italic>\u2009=\u20090.0119).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Moreover,73% satisfied female Rem\/Ra patients presented an acceptable pain compared to 23% unsatisfied female Rem\/RA patients (<jats:italic>p<\/jats:italic>\u2009=\u20090.001). RP in RA patients in remission can represent the way by which the patients communicate their state of non-acceptance of the disease. It can be useful to treat RP with the appropriate treatments.\n<jats:table-wrap>\n                <jats:table>\n                  <jats:tbody>\n                    <jats:tr>\n                      <jats:td colspan=\"2\">\n                        <jats:bold>Key Points<\/jats:bold>\u2022 <jats:italic>Rheumatoid arthritis patients still reported unacceptable residual pain despite sustained clinical and ultrasound remission and despite the low grade\/absence of histological synovitis.<\/jats:italic>\u2022 <jats:italic>Only a small rate of rheumatoid arthritis patients in sustained clinical and ultrasound remission showed residual pain as part of a central sensitivity syndrome or psychiatric disorders.<\/jats:italic>\u2022 <jats:italic>Rheumatoid arthritis patients in sustained clinical and ultrasound remission complained residual pain and fatigue as part of not acceptance of disease and\/or dissatisfaction in the disease management.<\/jats:italic>\n                      <\/jats:td>\n                    <\/jats:tr>\n                  <\/jats:tbody>\n                <\/jats:table>\n              <\/jats:table-wrap>\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s10067-025-07331-0","type":"journal-article","created":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T10:54:20Z","timestamp":1737543260000},"page":"1019-1029","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Residual pain and fatigue are affected by disease perception in rheumatoid arthritis in sustained clinical and ultrasound remission"],"prefix":"10.1007","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6918-4731","authenticated-orcid":false,"given":"Simone","family":"Perniola","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Bruno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Di Mario","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Campobasso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Calabretta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Gessi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Petricca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Tolusso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Alivernini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Gremese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,22]]},"reference":[{"issue":"1","key":"7331_CR1","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1136\/ard-2022-223356","volume":"82","author":"JS Smolen","year":"2023","unstructured":"Smolen JS, Landew\u00e9 RBM, Bergstra SA, Kerschbaumer A, Sepriano A, Aletaha D et al (2023) EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2022 update. 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