POS0976 HAND FUNCTION IS ALREADY REDUCED BEFORE RA-DEVELOPMENT AND REFLECTS SUBCLINICAL TENOSYNOVITIS

Background Clinically suspect arthralgia (CSA) is characterized by of small joints and considered a risk stage for development rheumatoid arthritis (RA). However, it remains unknown if the function hands already affected what mechanisms underlie impaired hand in CSA. Objectives We aimed to study extent CSA-patients, whether that would reflect underlying subclinical inflammation, can be value clinical practice. Methods studied various measures two CSA-populations. CSA-patients TREAT-EARLIER-trial (n=236) were evaluated at baseline for: grip strength on dynamometer, patient-reported difficulties grip-domain HAQ-questionnaire incomplete fist-closure physical examination. Contrast-enhanced MRI measured synovitis/tenosynovitis/osteitis (summed as inflammation). Findings validated an independent CSA-cohort (n=600) where hand-function was as: squeezing examiner’s fingers, HAQ-questionnaire, fist-closure. Results Grip (on dynamometer) reduced 75% compared reference-values healthy-controls (1), 60% reported grip-difficulties 13% had Reduced associated with inflammation (-0.38 kg per point 95%CI -0.68;-0.08). Studying separate MRI-features, reduction independently tenosynovitis, decreasing -2.63kg (-2.26; -0.33) tenosynovitis (range observed scores: 0-20). Similar relations seen (OR 1.12 point, 1.07;1.42) 1.36 1.03;1.79). In validation-cohort, 36% decreased examiner-assessed GS, 51% grip-difficulties, 14% fist-closure: all tenosynovitis. Decreased dynamometer-measured most sensitive detecting (75%), while specific (88-90%). Conclusion Hand often before RA-development, reflecting inflammation. practice, testing could conveniently objectify functional limitations reveal Reference [1]Günther CM, Bürger A, Rickert M, Crispin Schulz CU. healthy caucasian adults: reference values. The Journal surgery. 2008;33(4):558-65. Figure 1. Assessment prevalence CSA-phase Legend A depicts different used: I Dynamometer-measured (GS), II HAQ grip-domain, III fist-closure, IV Examiner-assessed. B, mean individuals same age sex Gunther et al.(1) Patient-reported defined score 1 or higher (i.e. indicating some difficulty, much difficulty unable perform task) domain. I, assessed derivation-cohort, II, validation-cohort. GS: strength. Acknowledgements thank G. Kracht (medical photographer) preparing Disclosure Interests None Declared.