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This study explored the diagnostic value of morning stiffness in 5,202 arthralgia and arthritis patients and the prognostic value in early rheumatoid arthritis (RA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In arthralgia patients referred to the Early Arthritis\n                      <jats:italic>Recognition<\/jats:italic>\n                      Clinics (EA\n                      <jats:italic>R<\/jats:italic>\n                      C) of Leiden (n\u2009=\u2009807) and Groningen (n\u2009=\u2009481) or included in the Rotterdam Early Arthritis Cohort (REACH) study (n\u2009=\u2009353), the associations (cross-sectional analyses) between morning stiffness and presence of arthritis at physical examination were studied. In early arthritis patients, included in the Leiden Early Arthritis Clinic (EAC) (n\u2009=\u20092,748) and Evaluation et Suivi de POlyarthrites Indiff\u00e9renci\u00e9es R\u00e9centes (ESPOIR) (n\u2009=\u2009813), associations with fulfilling the 2010-RA criteria after one year were assessed. In 2010-RA patients included in the EAC (n\u2009=\u20091,140) and ESPOIR (n\u2009=\u2009677), association with the long-term outcomes of disease-modifying antirheumatic drug (DMARD)-free sustained remission and radiological progression were determined. Morning stiffness was defined as a duration \u226560\u00a0minutes; sensitivity analyses were performed for other definitions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In arthralgia, morning stiffness (\u226560\u00a0minutes) associated with the presence of arthritis; Leiden EA\n                      <jats:italic>R<\/jats:italic>\n                      C odds ratio (OR) 1.49 (95% CI 1.001 to 2.20), Groningen EA\n                      <jats:italic>R<\/jats:italic>\n                      C OR 2.21 (1.33 to 3.69) and REACH OR 1.55 (0.97 to 2.47) but the areas under the receiver operating characteristic curve (AUCs) were low (0.52, 0.57, 0.54). In early arthritis, morning stiffness was associated with 2010-RA independent of other predictors (Leiden EAC OR 1.72 (95% CI 1.31 to 2.25, AUC 0.68), ESPOIR OR 1.68 (1.03 to 2.74, AUC 0.64)). Duration of \u226530\u00a0minutes provided optimal discrimination for RA in early arthritis. Morning stiffness was not associated with radiological progression or DMARD-free sustained remission.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Morning stiffness in arthralgia and early arthritis is associated with arthritis and RA respectively. This supports the incorporation of morning stiffness in the diagnostic process.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13075-015-0616-3","type":"journal-article","created":{"date-parts":[[2015,4,22]],"date-time":"2015-04-22T11:39:31Z","timestamp":1429702771000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Reappraisal of the diagnostic and prognostic value of morning stiffness in arthralgia and early arthritis: results from the Groningen EARC, Leiden EARC, ESPOIR, Leiden EAC and REACH"],"prefix":"10.1186","volume":"17","author":[{"given":"Jessica AB","family":"van Nies","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celina","family":"Alves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey LS","family":"Radix-Bloemen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9cile","family":"Gaujoux-Viala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom WJ","family":"Huizinga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna MW","family":"Hazes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Brouwer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Fautrel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette HM van der Helm-van","family":"Mil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2015,4,23]]},"reference":[{"key":"616_CR1","first-page":"1290","volume":"18","author":"F Wolfe","year":"1991","unstructured":"Wolfe F, Hawley DJ, Cathey MA. 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