{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T11:37:47Z","timestamp":1784547467901,"version":"3.55.0"},"reference-count":23,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T00:00:00Z","timestamp":1773532800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: In the perspective of an increasingly widespread application of precision medicine in rheumatoid arthritis (RA), this study aimed to compare efficacy and safety of ultrasound-guided synovial biopsy (US-SB) performed in an experienced rheumatology and community hospital setting. Methods: A post hoc analysis of R4RA, STRAP and STRAP-EU trials was performed, comparing US-SB performed in a radiology department of a community hospital without experience in RA (n = 14), versus a rheumatology academic centre with a high expertise in RA management and US-SB (n = 16). Suitability of specimens for histological and transcriptomic analysis (tissue and RNA quality) was analyzed as the main outcome. Results: Demographic and clinical features of the two patients\u2019 groups were similar, except of disease duration (p &lt; 0.05). No differences were recorded regarding site and ultrasound of the biopsied joint. Suitability for histological (% of gradable tissue) and transcriptomic analysis (RIN &gt;3) was similar in the two cohorts (both 85.7% vs. 87.5%, p = 0.88). Proportion of gradable biopsies in total (59.2% vs. 59.5%, p = 0.96) and for each patient (52% vs. 56.15%, p = 0.77), were similar in both cohorts. Adverse events were rare (two in community hospital cohort, one in rheumatology cohort, p = 0.54), none considered severe. Seven patients in the community hospital experienced mild or severe pain, only two referred the same in the rheumatology cohort (p = 0.04). Conclusions: US-SB can be safely and effectively performed in a community hospital without experience in RA. A larger diffusion of this technique could allow to pursuit a tailored approach also in ordinary rheumatology outpatient clinics.<\/jats:p>","DOI":"10.3390\/jcm15062233","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T08:41:26Z","timestamp":1773650486000},"page":"2233","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Ultrasound-Guided Synovial Biopsy Can Be Effectively and Safely Performed in Different Clinical Settings Favouring a Widespread Application of Precision Medicine in Rheumatoid Arthritis: A Post-hoc Analysis of Three Clinical Trials"],"prefix":"10.3390","volume":"15","author":[{"given":"Mattia","family":"Congia","sequence":"first","affiliation":[{"name":"Rheumatology Unit, Department of Medicine and Public Health, Azienda Ospedaliera Universitaria di Cagliari, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Marini","sequence":"additional","affiliation":[{"name":"Radiology Unit, SS Trinit\u00e0 Hospital, ATS Sardegna, 09121 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4064-4014","authenticated-orcid":false,"given":"Alessandra","family":"Nerviani","sequence":"additional","affiliation":[{"name":"Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felice","family":"Rivellese","sequence":"additional","affiliation":[{"name":"Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgina","family":"Thorborn","sequence":"additional","affiliation":[{"name":"Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Hands","sequence":"additional","affiliation":[{"name":"Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Maddalena","family":"Angioni","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Medicine and Public Health, Azienda Ospedaliera Universitaria di Cagliari, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Chessa","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Medicine and Public Health, Azienda Ospedaliera Universitaria di Cagliari, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9154-0576","authenticated-orcid":false,"given":"Alberto","family":"Floris","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Medicine and Public Health, Azienda Ospedaliera Universitaria di Cagliari, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piero","family":"Mascia","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Medicine and Public Health, Azienda Ospedaliera Universitaria di Cagliari, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1126-8315","authenticated-orcid":false,"given":"Matteo","family":"Piga","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Medicine and Public Health, Azienda Ospedaliera Universitaria di Cagliari, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances","family":"Humby","sequence":"additional","affiliation":[{"name":"Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Marcia","sequence":"additional","affiliation":[{"name":"Radiology Unit, SS Trinit\u00e0 Hospital, ATS Sardegna, 09121 Cagliari, 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