{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:02:28Z","timestamp":1790690548335,"version":"4.1.0"},"reference-count":34,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,3,4]],"date-time":"2022-03-04T00:00:00Z","timestamp":1646352000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Ministry of Health, Labor, and Welfare of Japan","award":["19FE1003"],"award-info":[{"award-number":["19FE1003"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>We investigated the relationship between distal interphalangeal (DIP) joint involvement and disease activity in 10,038 patients with adult-onset rheumatoid arthritis (RA). The affected joint distribution was investigated using the joint indices (JI) x, y, and z, corresponding to the upper and lower joints, and the predominance of large-joint involvement, respectively. DIP joint involvement (defined by the presence of tenderness and\/or swelling in DIP joints) was present in 206 (2.1%) of 10,038 patients with RA. Patients with RA exhibiting DIP joint involvement were significantly younger, and more frequently women. DIP joint involvement was positively associated with Disease Activity Score-28 using C-reactive protein, and clinical variables related to high RA disease activity, including JIs x and y, and was negatively associated with JI z. JI x was significantly higher than JI y in RA patients with DIP joint involvement. An odds ratio analysis revealed that small-to-medium sized and upper-extremity joints ranked first, second, and fourth among the eight variables significantly associated with DIP joint involvement. The correlation coefficients revealed that small-sized and upper-extremity joints ranked first and second among the five significant variables. DIP joint involvement, albeit rare, is significantly associated with high RA disease activity with predominance of small-sized and upper-extremity joints.<\/jats:p>","DOI":"10.3390\/jcm11051405","type":"journal-article","created":{"date-parts":[[2022,3,6]],"date-time":"2022-03-06T20:38:16Z","timestamp":1646599096000},"page":"1405","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Distal Interphalangeal Joint Involvement May Be Associated with Disease Activity and Affected Joint Distribution in Rheumatoid Arthritis"],"prefix":"10.3390","volume":"11","author":[{"given":"Takahiro","family":"Mizuuchi","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Tokyo Medical University Hospital, 6-7-1 Nishi-Shinjuku, Shinjuku, Tokyo 160-0023, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuji","family":"Sawada","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Tokyo Medical University Hospital, 6-7-1 Nishi-Shinjuku, Shinjuku, Tokyo 160-0023, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susumu","family":"Nishiyama","sequence":"additional","affiliation":[{"name":"Rheumatic Disease Center, Kurashiki Medical Center, 250 Bakuro, Kurashiki 710-8522, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichiro","family":"Tahara","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Tokyo Medical University Hospital, 6-7-1 Nishi-Shinjuku, Shinjuku, Tokyo 160-0023, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haeru","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Tokyo Medical University Hospital, 6-7-1 Nishi-Shinjuku, Shinjuku, Tokyo 160-0023, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Tokyo Medical University Hospital, 6-7-1 Nishi-Shinjuku, Shinjuku, Tokyo 160-0023, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eri","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Tokyo Medical University Hospital, 6-7-1 Nishi-Shinjuku, Shinjuku, Tokyo 160-0023, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayu","family":"Tago","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Tokyo Medical University Hospital, 6-7-1 Nishi-Shinjuku, Shinjuku, Tokyo 160-0023, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihiro","family":"Matsui","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, 18-1 Sakuradai, Minami, Sagamihara 252-0392, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeto","family":"Tohma","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, National Hospital Organization, Tokyo National Hospital, 3-1-1 Takeoka, Kiyose 204-8585, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,4]]},"reference":[{"key":"ref_1","unstructured":"Firestein, G., Budd, R., Gabriel, S., Koretzky, G., McInnes, I., and O\u2019Dell, J. (2020). Clinical features of rheumatoid arthritis. Firestein & Kelly\u2019s Textbook of Rheumatology, Elsevier. [11th ed.]."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1136\/ard.35.4.361","article-title":"Early rheumatoid disease. II. Patterns of joint involvement","volume":"35","author":"Fleming","year":"1976","journal-title":"Ann. Rheum. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.7326\/AITC201901010","article-title":"Rheumatoid Arthritis","volume":"170","author":"Sparks","year":"2019","journal-title":"Ann. Intern. Med."},{"key":"ref_4","unstructured":"Sterling, G.W. (2020). Arthritis associated with psoriasis and other skin diseases. Rheumatology Secrets, Elsevier. [4th ed.]."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1745","DOI":"10.1016\/S0140-6736(19)30417-9","article-title":"Osteoarthritis","volume":"393","author":"Hunter","year":"2019","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1002\/art.1780090302","article-title":"Erosive osteoarthritis of the hands","volume":"9","author":"Peter","year":"1966","journal-title":"Arthritis Rheum."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1601","DOI":"10.1002\/art.1780331101","article-title":"The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand","volume":"33","author":"Altman","year":"1990","journal-title":"Arthritis Rheum."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1038\/nrrheum.2011.170","article-title":"Hand osteoarthritis\u2014A heterogeneous disorder","volume":"8","author":"Kloppenburg","year":"2011","journal-title":"Nat. Rev. Rheumatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2015","DOI":"10.1002\/art.41757","article-title":"Erosive Hand Osteoarthritis: Incidence and Predictive Characteristics Among Participants in the Osteoarthritis Initiative","volume":"73","author":"McAlindon","year":"2021","journal-title":"Arthritis Rheumatol."},{"key":"ref_10","first-page":"ii61","article-title":"Psoriatic arthritis imaging: A review of scoring methods","volume":"64","author":"Sharp","year":"2005","journal-title":"Ann. Rheum. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"202","DOI":"10.3109\/03009742.2013.835865","article-title":"Pattern of bone erosion and bone proliferation in psoriatic arthritis hands: A high-resolution computed tomography and radiography follow-up study during adalimumab therapy","volume":"43","author":"Poggenborg","year":"2014","journal-title":"Scand. J. Rheumatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1002\/art.1780290102","article-title":"Distal interphalangeal joint involvement in rheumatoid arthritis","volume":"29","author":"Jacob","year":"1986","journal-title":"Arthritis Rheum."},{"key":"ref_13","unstructured":"Kelley, W., Harris, E., Ruddy, S., and Sledge, C. (1981). Rheumatoid arthritis: The clinical spectrum. Textbook of Rheumatology, WB Saunders."},{"key":"ref_14","unstructured":"McCarty, D. (1985). Clinical picture of rheumatoid arthritis. Arthritis and Allied Condition, Lea & Febiger. [10th ed.]."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1002\/art.1780090208","article-title":"A study of distal interphalangeal joint tenderness in rheumatoid arthritis","volume":"9","author":"McCarty","year":"1966","journal-title":"Arthritis Rheum."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2569","DOI":"10.1007\/s00296-011-2058-9","article-title":"Proposing a method of regional assessment and a novel outcome measure in rheumatoid arthritis","volume":"32","author":"Nishiyama","year":"2012","journal-title":"Rheumatol. Int."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1186\/s40537-018-0148-1","article-title":"Joint index vector: A novel assessment measure for stratified medicine in patients with rheumatoid arthritis","volume":"5","author":"Nishiyama","year":"2018","journal-title":"J. Big Data"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"75","DOI":"10.3109\/s10165-006-0464-8","article-title":"Potential impact of observational cohort studies in Japan on rheumatoid arthritis research and practice","volume":"16","author":"Yamanaka","year":"2006","journal-title":"Mod. Rheumatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2569","DOI":"10.1002\/art.27584","article-title":"2010 Rheumatoid arthritis classification criteria: An American College of Rheumatology\/European League Against Rheumatism collaborative initiative","volume":"62","author":"Aletaha","year":"2010","journal-title":"Arthritis Rheum."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1002\/art.1780310302","article-title":"The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis","volume":"31","author":"Arnett","year":"1988","journal-title":"Arthritis Rheum."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1001\/jama.1949.02900430001001","article-title":"Therapeutic criteria in rheumatoid arthritis","volume":"140","author":"Steinbrocker","year":"1949","journal-title":"J. Am. Med. Assoc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1002\/art.1780360601","article-title":"The American College of Rheumatology preliminary core set of disease activity measures for rheumatoid arthritis clinical trials. The Committee on Outcome Measures in Rheumatoid Arthritis Clinical Trials","volume":"36","author":"Felson","year":"1993","journal-title":"Arthritis Rheum."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"S14","DOI":"10.1002\/acr.20621","article-title":"Measures of rheumatoid arthritis disease activity: Patient (PtGA) and Provider (PrGA) Global Assessment of Disease Activity, Disease Activity Score (DAS) and Disease Activity Score with 28-Joint Counts (DAS28), Simplified Disease Activity Index (SDAI), Clinical Disease Activity Index (CDAI), Patient Activity Score (PAS) and Patient Activity Score-II (PASII), Routine Assessment of Patient Index Data (RAPID), Rheumatoid Arthritis Disease Activity Index (RADAI) and Rheumatoid Arthritis Disease Activity Index-5 (RADAI-5), Chronic Arthritis Systemic Index (CASI), Patient-Based Disease Activity Score with ESR (PDAS1) and Patient-Based Disease Activity Score without ESR (PDAS2), and Mean Overall Index for Rheumatoid Arthritis (MOI-RA)","volume":"63","author":"Anderson","year":"2011","journal-title":"Arthritis Care Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1136\/ard.2006.054205","article-title":"Comparison of Disease Activity Score (DAS)28-erythrocyte sedimentation rate and DAS28-C-reactive protein threshold values","volume":"66","author":"Inoue","year":"2007","journal-title":"Ann. Rheum. Dis."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e18218","DOI":"10.1097\/MD.0000000000018218","article-title":"Association of HLA-DRB1 genotype with younger age onset and elder age onset rheumatoid arthritis in Japanese populations","volume":"98","author":"Oka","year":"2019","journal-title":"Medicine"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1016\/j.ajhg.2019.08.002","article-title":"Distinct HLA Associations with Rheumatoid Arthritis Subsets Defined by Serological Subphenotype","volume":"105","author":"Terao","year":"2019","journal-title":"Am. J. Hum. Genet."},{"key":"ref_27","first-page":"157","article-title":"Predominance of large joint active synovitis in Asian patients with established rheumatoid arthritis","volume":"34","author":"Cheung","year":"2016","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1136\/ard.45.4.327","article-title":"Small joint involvement: A systematic roentgenographic study in rheumatoid arthritis","volume":"45","author":"Halla","year":"1986","journal-title":"Ann. Rheum. Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2284","DOI":"10.1002\/art.21221","article-title":"Increased radiographic damage scores at the onset of seropositive rheumatoid arthritis in older patients are associated with osteoarthritis of the hands, but not with more rapid progression of damage","volume":"52","author":"Khanna","year":"2005","journal-title":"Arthritis Rheum."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1002\/art.40684","article-title":"Brief Report: Influence of disease activity in rheumatoid arthritis on radiographic progression of concomitant interphalangeal joint osteoarthritis","volume":"71","author":"Lechtenboehmer","year":"2019","journal-title":"Arthritis Rheumatol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1002\/acr.21586","article-title":"Distribution of finger nodes and their association with underlying radiographic features of osteoarthritis","volume":"64","author":"Rees","year":"2012","journal-title":"Arthritis Care Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1111\/j.1365-2133.2007.08139.x","article-title":"Multidisciplinary evaluation of patients with psoriasis presenting with musculoskeletal pain: A dermatology: Rheumatology clinic experience","volume":"157","author":"Mody","year":"2007","journal-title":"Br. J. Dermatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2040622319847900","DOI":"10.1177\/2040622319847900","article-title":"Prevalence, clinical features and treatment pattern of patients with concurrent diagnoses of rheumatoid arthritis and psoriatic disease: Results of a 14-year retrospective study in a tertiary referral center","volume":"10","author":"Chen","year":"2019","journal-title":"Ther. Adv. Chronic Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1111\/1756-185X.12998","article-title":"The age at onset of rheumatoid arthritis is increasing in Japan: A nationwide database study","volume":"20","author":"Kato","year":"2017","journal-title":"Int. J. Rheum. Dis."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/5\/1405\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:31:49Z","timestamp":1760135509000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/5\/1405"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,4]]},"references-count":34,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,3]]}},"alternative-id":["jcm11051405"],"URL":"https:\/\/doi.org\/10.3390\/jcm11051405","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,4]]}}}