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The authors of a new study have identified 3 ultrasonography biomarkers that can predict the development of arthritis among individuals at risk for rheumatoid arthritis (RA). The findings were released during the American College of Rheumatology’s (ACR) annual meeting, ACR Convergence.

The researchers identified the biomarkers—tenosynovitis, synovial hypertrophy, and bursitis—by analyzing data on 288 participants of the RISK RA study.

To be included in the study, the participants had to have been referred to a rheumatology unit after having experienced musculoskeletal symptoms indicative of rheumatic disease and after having a positive anti-cyclic citrullinated peptide 2 test.

In total, 68 joint counts by ultrasonography examination were performed. Based on the European League Against Rheumatism-Outcome Measures in Rheumatologydefinitions, the ultrasonography results were scored for synovial hypertrophy and Doppler activity. The individuals without arthritis—defined by clinical examination and ultrasonography—were included in the RISK RA prospective cohort. 

Additionally, finger and wrist tendons were examined for any signs of tenosynovitis, including evaluations between joints for bursitis. 

Within a median of 38 months since recruitment, 28% of the participants progressed to arthritis. Among the one-third of participants who had at least 1 ultrasonography change of tenosynovitis, synovial hypertrophy without Doppler, and/or bursitis, 56% developed arthritis. 

The researchers determined that tenosynovitis, synovial hypertrophy, and bursitis are useful ultrasonography biomarkers in the prediction of arthritis development among individuals at risk for RA after finding the following:

• Tenosynovitis was detected among 22% of all participants. It was detected in 37 of the 84 participants (44%) developing arthritis and in 27 of the 204 of participants (13%) who were not developing arthritis. The extensor carpi ulnaris wrist tendons were mostly affected. 
• Synovial hypertrophy (grade 1 or 2) was detected among 11% of all participants. It was detected in 18 of the 84 participants (21%) developing arthritis and in 14 of the 204 participants (7%) who were not developing arthritis. The metacarpophalangeal (MTP) joints were mostly affected.
• Bursitis between MTP joints was detected among 9% of all participants. It was detected in 11 of the 84 participants (13%) developing arthritis and in 14 of the 204 of participants (7%) who were not developing arthritis.

—Colleen Murphy

Reference:

Kisten Y, Circiumaru A, Loberg-Haarhaus M, al. Presence of ultrasound imaging biomarkers are good predictors of arthritis development in a population at risk for rheumatoid arthritis. Study presented at: American College of Rheumatology Convergence 2020; November 5-9, 2020; Virtual. Accessed November 4, 2020. https://acrabstracts.org/abstract/presence-of-ultrasound-imaging-biomarkers-are-good-predictors-of-arthritis-development-in-a-population-at-risk-for-rheumatoid-arthritis/