{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T17:25:07Z","timestamp":1757611507808,"version":"3.44.0"},"reference-count":42,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2016,1,7]]},"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To evaluate the predictive value of tender joints compared to synovitis for structural damage in rheumatoid arthritis (RA).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A post hoc analysis was performed on a prospective 2-year study of 59 patients with active RA starting on antitumour necrosis factor (TNF). Tenderness and synovitis was assessed clinically at baseline, followed by blinded ultrasound assessment (B-mode and power Doppler ultrasound (PDUS)) on the hands and feet (2 wrists, 10 metacarpophalangeal, 10 proximal interphalangeal and 10 metatarsophalangeal (MTP) joints). Radiographs of these joints were performed at baseline and at 2\u2005years. The risk of radiographic progression with respect to the presence of baseline tenderness or synovitis, as well as its persistence (after 4\u2005months of anti-TNF), was estimated by OR (95% CI).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Baseline tender joints were the least predictive for radiographic progression (OR=1.53 (95% CI 1.02 to 2.29) p&lt;0.04), when compared to synovitis (clinical OR=2.08 (95% CI 1.39 to 3.11) p&lt;0.001 or PDUS OR=1.80 (95% CI 1.20 to 2.71) p=0.005, respectively). Tender joints with the presence of synovitis were predictive of radiographic progression (OR=1.89 (95% CI 1.25 to 2.85) p=0.002), especially seen in the MTP joints. Non-tender joints with no synovitis were negatively predictive (OR=0.57 (95% CI 0.39 to 0.82) p=0.003). Persistence of tender joints was negatively predictive (OR=0.38 (95% CI 0.18 to 0.78) p=0.009) while persistence of synovitis was predictive (OR=2.41 (95% CI 1.24 to 4.67) p=0.01) of radiographic progression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Synovitis is better than tenderness to predict for subsequent structural progression. However, coexistence of tenderness and synovitis at the level of an individual joint is predictive of structural damage, particularly in the MTP joints.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>NCT00444691.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2015-000205","type":"journal-article","created":{"date-parts":[[2016,3,17]],"date-time":"2016-03-17T21:39:21Z","timestamp":1458250761000},"page":"e000205","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Predictive value of tender joints compared to synovitis for structural damage in rheumatoid arthritis"],"prefix":"10.1136","volume":"2","clinical-trial-number":[{"clinical-trial-number":"nct00444691","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct00444691","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Peter P","family":"Cheung","sequence":"first","affiliation":[{"name":"Division of Rheumatology, National University Hospital, Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karine","family":"Mari","sequence":"additional","affiliation":[{"name":"RCTs, Lyon, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Val\u00e9rie","family":"Devauchelle-Pensec","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, CHU de la Cavale Blanche, Boulevard Tanguy Prigent, Brest, France"},{"name":"EA 2216, INSERM ESPRI, ERI29 Universit\u00e9 Bretagne Occidentale, Brest, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandrine","family":"Jousse-Joulin","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, CHU de la Cavale Blanche, Boulevard Tanguy Prigent, Brest, France"},{"name":"EA 2216, INSERM ESPRI, ERI29 Universit\u00e9 Bretagne Occidentale, Brest, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Antonietta","family":"D'Agostino","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, APHP, Ambrose-Par\u00e9, Versailles-Saint Quentin en Yvelines University, Boulogne-Billancourt, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00e9rard","family":"Chal\u00e8s","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, H\u00f4pital Sud, CHU Rennes, Rennes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Gaudin","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, University Hospital, Grenoble, H\u00f4pital Sud, Echirolles, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xavier","family":"Mariette","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, H\u00f4pitaux Universitaires Paris-Sud; Universit\u00e9 Paris-Sud; INSERM U1012; Le Kremlin Bic\u00eatre, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alain","family":"Saraux","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, CHU de la Cavale Blanche, Boulevard Tanguy Prigent, Brest, France"},{"name":"EA 2216, INSERM ESPRI, ERI29 Universit\u00e9 Bretagne Occidentale, Brest, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maxime","family":"Dougados","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, H\u00f4pital Cochin, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,3,17]]},"reference":[{"key":"2025090312450054000_2.1.e000205.1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.124347"},{"key":"2025090312450054000_2.1.e000205.2","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200109)44:9<2009::AID-ART349>3.0.CO;2-L"},{"key":"2025090312450054000_2.1.e000205.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2004.08.004"},{"key":"2025090312450054000_2.1.e000205.4","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keg235"},{"key":"2025090312450054000_2.1.e000205.5","first-page":"393","article-title":"Clinical studies with an articular index for the assessment of joint tenderness in patients with rheumatoid arthritis","volume":"37","author":"Ritchie","year":"1968","journal-title":"Q J Med"},{"key":"2025090312450054000_2.1.e000205.6","first-page":"716","article-title":"Grading of tenderness as a source of interrater error in the Ritchie articular index","volume":"12","author":"Hart","year":"1985","journal-title":"J Rheumatol"},{"key":"2025090312450054000_2.1.e000205.7","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780360601"},{"key":"2025090312450054000_2.1.e000205.8","first-page":"579","article-title":"Development of a disease activity score based on judgment in clinical practice by rheumatologists","volume":"20","author":"van der Heijde","year":"1993","journal-title":"J Rheumatol"},{"key":"2025090312450054000_2.1.e000205.9","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1002\/acr.20178","article-title":"Reliability of patient self-evaluation of swollen and tender joints in rheumatoid arthritis: a comparison study with ultrasonography, physician, and nurse assessments","volume":"62","author":"Cheung","year":"2010","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2025090312450054000_2.1.e000205.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2013.11.003"},{"key":"2025090312450054000_2.1.e000205.11","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1002\/anr.1780320907","article-title":"Which traditional measures should be used in rheumatoid arthritis clinical trials?","volume":"32","author":"Anderson","year":"1989","journal-title":"Arthritis Rheum"},{"key":"2025090312450054000_2.1.e000205.12","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.126953"},{"key":"2025090312450054000_2.1.e000205.13","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2011.151316"},{"key":"2025090312450054000_2.1.e000205.14","doi-asserted-by":"publisher","DOI":"10.1002\/art.30634"},{"key":"2025090312450054000_2.1.e000205.15","doi-asserted-by":"publisher","DOI":"10.1002\/art.33312"},{"key":"2025090312450054000_2.1.e000205.16","doi-asserted-by":"publisher","DOI":"10.1002\/art.22461"},{"key":"2025090312450054000_2.1.e000205.17","doi-asserted-by":"publisher","DOI":"10.1002\/art.11481"},{"key":"2025090312450054000_2.1.e000205.18","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-201469"},{"key":"2025090312450054000_2.1.e000205.19","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199809)41:9<1571::AID-ART7>3.0.CO;2-R"},{"key":"2025090312450054000_2.1.e000205.20","doi-asserted-by":"publisher","DOI":"10.1002\/art.21678"},{"key":"2025090312450054000_2.1.e000205.21","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.115493"},{"key":"2025090312450054000_2.1.e000205.22","unstructured":"Association de Recherche Clinique en Rhumatologie. 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Bethesda, MD: National Library of Medicine (US), 2000 [cited 2015 Dec 27]. http:\/\/clinicaltrials.gov\/show\/NCT00444691 NLM Identifier: NCT00444691 ."},{"key":"2025090312450054000_2.1.e000205.23","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780310302"},{"key":"2025090312450054000_2.1.e000205.24","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.090881"},{"key":"2025090312450054000_2.1.e000205.25","first-page":"2485","article-title":"Musculoskeletal ultrasound including definitions for ultrasonographic pathology","volume":"32","author":"Wakefield","year":"2005","journal-title":"J Rheumatol"},{"key":"2025090312450054000_2.1.e000205.26","doi-asserted-by":"publisher","DOI":"10.1002\/art.20939"},{"key":"2025090312450054000_2.1.e000205.27","doi-asserted-by":"publisher","DOI":"10.1002\/art.10877"},{"key":"2025090312450054000_2.1.e000205.28","first-page":"1511","article-title":"Performance of hand radiographs in predicting the diagnosis in patients with early arthritis","volume":"33","author":"Devauchelle-Pensec","year":"2006","journal-title":"J Rheumatol"},{"key":"2025090312450054000_2.1.e000205.29","first-page":"66","article-title":"Ability of foot radiographs to predict rheumatoid arthritis in patients with early arthritis","volume":"31","author":"Devauchelle-Pensec","year":"2004","journal-title":"J Rheumatol"},{"key":"2025090312450054000_2.1.e000205.30","first-page":"2603","article-title":"Ability of hand radiographs to predict a further diagnosis of rheumatoid arthritis in patients with early arthritis","volume":"28","author":"Devauchelle-Pensec","year":"2001","journal-title":"J Rheumatol"},{"key":"2025090312450054000_2.1.e000205.31","doi-asserted-by":"publisher","DOI":"10.2307\/2531248"},{"key":"2025090312450054000_2.1.e000205.32","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.090879"},{"key":"2025090312450054000_2.1.e000205.33","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1016\/S0140-6736(89)92442-2","article-title":"Effects of hydroxychloroquine and sulphasalazine on progression of joint damage in rheumatoid arthritis","volume":"1","author":"Van der Heijde","year":"1989","journal-title":"Lancet"},{"key":"2025090312450054000_2.1.e000205.34","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1177\/028418517701800415","article-title":"Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference films","volume":"18","author":"Larsen","year":"1977","journal-title":"Acta Radiol Diagn"},{"key":"2025090312450054000_2.1.e000205.35","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200108)44:8<1736::AID-ART308>3.0.CO;2-I"},{"key":"2025090312450054000_2.1.e000205.36","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.091446"},{"key":"2025090312450054000_2.1.e000205.37","doi-asserted-by":"publisher","DOI":"10.1002\/art.30129"},{"key":"2025090312450054000_2.1.e000205.38","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200009)43:9<1927::AID-ANR3>3.0.CO;2-B"},{"key":"2025090312450054000_2.1.e000205.39","first-page":"1739","article-title":"Ability of oblique radiographs to detect erosions in early arthritis: results in the ESPOIR cohort","volume":"59","author":"Devauchelle-Pensec","year":"2008","journal-title":"Arthritis Rheum"},{"key":"2025090312450054000_2.1.e000205.40","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2011-146670"},{"key":"2025090312450054000_2.1.e000205.41","doi-asserted-by":"publisher","DOI":"10.1002\/art.23945"},{"key":"2025090312450054000_2.1.e000205.42","doi-asserted-by":"publisher","DOI":"10.1002\/art.24596"}],"container-title":["RMD Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rmdopen-2015-000205","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T19:45:08Z","timestamp":1756928708000},"score":1,"resource":{"primary":{"URL":"https:\/\/rmdopen.bmj.com\/lookup\/doi\/10.1136\/rmdopen-2015-000205"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,3]]},"references-count":42,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2016,3,17]]},"published-print":{"date-parts":[[2016,3]]}},"alternative-id":["10.1136\/rmdopen-2015-000205"],"URL":"https:\/\/doi.org\/10.1136\/rmdopen-2015-000205","relation":{},"ISSN":["2056-5933"],"issn-type":[{"type":"electronic","value":"2056-5933"}],"subject":[],"published":{"date-parts":[[2016,3]]}}}