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The use of MRI-detected synovitis to determine the number of involved joints for the 2010 ACR/EULAR classification criteria for Rheumatoid Arthritis - is it of additional benefit?

ABSTRACT: OBJECTIVE:To assess the value of MRI-detected synovitis to determine the number of involved joints on the performance of the 2010-ACR/EULAR classification criteria for rheumatoid arthritis (RA). METHODS:277 patients with a clinical suspicion of RA consecutively included in the Leiden Early Arthritis Clinic (EAC)-cohort underwent 1.5T MRI of MCP-, wrist- and MTP-joints. Test characteristics of the 2010-criteria were calculated when the number of involved joints was determined with and without including MRI-detected synovitis. Two outcomes were studied: disease modifying anti-rheumatic drug (DMARD)-initiation and 1987-criteria fulfilment during the first year. RESULTS:At baseline, 143 patients were classified as RA. When MRI-detected synovitis was considered, 14 patients additionally fulfilled the 2010-criteria. Of these, 64% (9/14) started DMARDs. When MRI-detected synovitis was also used to determine the number of involved joints the sensitivity changed from 62% to 67%, the specificity from 90% to 84% and the AUC from 0.76 to 0.75. The net reclassification index was -2.4%. When fulfilling the 1987-criteria was used as outcome, results were similar. CONCLUSION:We found no scientific support that the use of MRI-detected synovitis is of additional benefit for the performance of the 2010 classification criteria.

SUBMITTER: Boer AC

PROVIDER: S-EPMC6298578 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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The use of MRI-detected synovitis to determine the number of involved joints for the 2010 ACR/EULAR classification criteria for Rheumatoid Arthritis - is it of additional benefit?

Boer Aleid C AC Boeters Debbie M DM van der Helm-van Mil Annette H M AHM

Annals of the rheumatic diseases 20180420 8

<h4>Objective</h4>To assess the value of MRI-detected synovitis to determine the number of involved joints on the performance of the 2010-ACR/EULAR classification criteria for rheumatoid arthritis (RA).<h4>Methods</h4>277 patients with a clinical suspicion of RA consecutively included in the Leiden Early Arthritis Clinic (EAC)-cohort underwent 1.5T MRI of MCP-, wrist- and MTP-joints. Test characteristics of the 2010-criteria were calculated when the number of involved joints was determined with ...[more]

PMID: 29678939

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Project description:BackgroundThe aim of this study was to validate the 2019 European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) classification criteria for systemic lupus erythematosus (SLE) in antinuclear antibody (ANA)-positive Chinese patients.MethodsMedical records of all adult patients who attended the rheumatology out-patient clinics between May and September 2019 were reviewed. Patients with ever ANA positive (titre ⩾1:80) were included and evaluated for the fulfilment of the 2019 EULAR/ACR, 2012 Systemic Lupus International Collaborating Clinics (SLICC) and 1997 ACR criteria for SLE classification. The performance of these criteria in predicting a clinical diagnosis of SLE as judged by an independent panel of rheumatologists was studied and compared in different subgroups.ResultsA total of 1533 patients (88.2% women; age at first clinic attendance 45.5 ± 15.6 years) were studied and 562 patients were judged to be clinical SLE. The sensitivity and specificity of the EULAR/ACR (⩾10 points), SLICC and ACR criteria for a clinical diagnosis of SLE was 96.1%, 97.9% and 86.1%; and 85.8%, 86.3% and 94.3%, respectively. Applying the attribution rule to the non-SLE controls, the specificity of the three criteria increased to 95.0%, 92.5% and 98.8%, respectively. The specificity of the EULAR/ACR criteria was higher in male patients (97.9%), those aged >50 years (97.0%) and disease duration of ⩽3 years (97.6%). Using a cut-off of 12 points, the specificity of the EULAR/ACR criteria was further increased (96.6%) while a high sensitivity (95.0%) was maintained.ConclusionIn Chinese patients with a positive ANA, the EULAR/ACR criteria for clinical SLE perform equally well to the SLICC criteria. Both the EULAR/ACR and SLICC are more sensitive but less specific than the ACR criteria. The specificity of all the three criteria is enhanced by applying the attribution rule to controls. The specificity of the EULAR/ACR criteria is higher in certain patient subgroups or when the cut-off score is raised.

Dataset Information

The use of MRI-detected synovitis to determine the number of involved joints for the 2010 ACR/EULAR classification criteria for Rheumatoid Arthritis - is it of additional benefit?

Publications

The use of MRI-detected synovitis to determine the number of involved joints for the 2010 ACR/EULAR classification criteria for Rheumatoid Arthritis - is it of additional benefit?

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