Subclinical synovitis in arthralgia: how often does it result in clinical arthritis? Reflecting on starting points for disease-modifying anti-rheumatic drug treatment.
Cleo RogierFenne WoutersLaurette van BoheemenDirkjan van SchaardenburgPascal Hendrik Pieter de JongAnnette H M van der Helm van MilPublished in: Rheumatology (Oxford, England) (2021)
Replacing clinical arthritis with subclinical synovitis to identify RA introduces a high false-positive rate (44-89%). These data suggest an overestimation regarding the value of ACPA positivity in combination with the presence of subclinical synovitis in patients with arthralgia, which harbours the risk of overtreatment if DMARDs are initiated in the absence of clinical arthritis.