Do MRI-detected erosions in the RA-risk phase of arthralgia reflect current or imminent radiographic erosions?: A large longitudinal imaging study
Bibliographic record
Abstract
Objectives Radiographic erosions of hands and feet are a hallmark of rheumatoid arthritis (RA) and treatment aims to prevent radiographic progression. In the at-risk phase of clinically suspect arthralgia (CSA), erosions on radiographs are rare but can be visible on MRI, which is a more sensitive imaging technique. However, the value of these MRI erosions and especially the relation with radiographic erosions is unknown. Therefore, we aimed to study if MRI-detected erosions in CSA (i) correspond with simultaneous radiographic erosions and (ii) associate with local radiographic progression.Methods Patients included in the Leiden CSA cohort (2012-2021) were followed until RA development or for 2 years. Unilateral hand-and-foot baseline MRIs were scored for erosions (RAMRIS score >= 1) and subclinical inflammation (synovitis/tenosynovitis/osteitis). Serial hand and foot radiographs (baseline, 12 and 24 months) were scored for erosions [Sharp-van-der-Heijde erosion-score (SHS) >= 1] and progression (delta-SHS >= 1). Generalized estimating equation evaluated if MRI erosions associated with radiographic erosions or progression in the same bone. Additionally, analyses were repeated considering concomitant MRI-detected subclinical inflammation.Results A total of 190/405 CSA patients (47%) had MRI-detected erosions at one or more of the 23 studied bone locations. An MRI-detected erosion associated with a local radiographic erosion [OR 5.23 (95%CI2.78-9.86)]; but in 96.5% of locations with an MRI-detected erosion a radiographic erosion was absent. MRI erosions with concomitant local subclinical inflammation revealed a stronger association [OR 6.29(2.94-13.48)]. Local radiographic progression was rare (0.4%). MRI erosions at baseline did not predict radiographic progression [OR 1.75(0.52-5.85)].Conclusion The majority of MRI-detected erosions in CSA patients does not correspond with radiographic erosive disease or progression. Therefore, MRI-detected erosions in this risk phase, especially without inflammation, should be regarded with caution to avoid overinterpretation.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".