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The following is a summary of “Imaging tests as predictors of progression to rheumatoid arthritis in clinically suspect arthralgia: A systematic review & meta-analysis ,” published in the January 2025 issue of Rheumatology by Gupta et al.
Researchers conducted a prospective study to evaluate the diagnostic accuracy of imaging tests in predicting rheumatoid arthritis (RA) progression in individuals with inflammatory joint pain or clinically suspect arthralgia (CSA).
They searched MEDLINE, Embase, and Web of Science from 1987 to March 2024 for studies on imaging tests in participants with inflammatory joint pain or CSA, excluding those with clinical synovitis. Reference standards included RA classification criteria, methotrexate initiation, or development of inflammatory arthritis (IA). Data were independently extracted by 2 authors, and validity was assessed using QUADAS-2. Summary sensitivities and specificities for each imaging characteristic were estimated, and bivariate and hierarchical SROC models were fitted for meta-analysis where applicable.
The results showed that 39 eligible studies with 42 cohorts were included: 12 evaluated MRI (n = 2,782; 19% with RA/IA), 26 evaluated ultrasounds (US) (n = 6,805; 25% with RA/IA), and 10 evaluated other imaging tests (n = 3,362; 20% with RA/IA). Summary sensitivity and specificity for US Power Doppler ≥1 in at least 1 joint were 37% (95%CI 18%-60%) and 90% (95%CI 82%-94%), respectively (7 studies). Summary sensitivity and specificity for MRI synovitis in at least 1 joint were 45% (95%CI 29%-62%) and 84% (95%CI 66%-94%), respectively (4 studies).
Investigators concluded that MRI and ultrasound showed heterogeneous and variable results in predicting RA/IA in people with CSA. Further studies with larger sample sizes, longer follow-up, and uniform scoring were needed to predict RA in this population better.
Source: academic.oup.com/rheumatology/advance-article/doi/10.1093/rheumatology/keaf045/7979252