Arthritis of the large joints--in particular, the knee--at first presentation is predictive for a high level of radiological destruction of the small joints in rheumatoid arthritis

What is the evidence for the presence of a therapeutic window of opportunity in rheumatoid arthritis? A systematic literature review

“…After detailed review, 22 articles satisfied the inclusion and exclusion criteria 9–30. Four of these were excluded, since they concerned duplicate patient populations (two were based on the Leiden Early Arthritis Clinic,20 29 one publication on the BeSt trial19 and one publication on the FINRACo trial26). Consequently, in total, 18 articles were used for further analyses (see table 2).…”

Whole-body FDG-PET/CT on rheumatoid arthritis of large joints

“…Linn-Rasker et al examined the predictive value of the distribution of inflamed joints at first presentation for the severity and disease course of RA using physical examination and various laboratory parameters. They concluded that the presence of arthritis in large joints, particularly arthritis in the knee joint, was predictive of a destructive disease course [17]. The evaluation of large joints with arthritis using whole-body FDG-PET/CT may be helpful for identifying patients with RA who may have a potentially severe disease course, including subluxation of the atlanto-axial joint, thereby contributing to considerations of therapeutic strategies.…”

A Multicenter Retrospective Analysis Evaluating Performance of Synovial Biopsy Techniques in Patients With Inflammatory Arthritis

“…The demonstration that minimally invasive USguided procedures can reliably sample the small joints as well as the large joints and, furthermore, do not require purchase of additional equipment (such as a small bore arthroscope) makes their inclusion in clinical trial protocols particularly attractive. Their adoption not only increases the potential pool of participants but also has the potential to reduce sampling bias because patients with a spectrum of disease severity can be recruited without being limited by the distribution of joints with active disease (e.g., the knee is often a preferred site for arthroscopy) (22). Intuitively, it may be assumed that US-NB retrieves tissue primarily from within, rather than at the surface of, synovial tissue, but this is not supported by the results of our study, since we demonstrated that US-NB is at least equivalent to US-P&F in obtaining synovial tissue with visible lining layer.…”