AI asymmetry measurement on hand X-rays predicts RA joint space narrowing

In radiographically normal rheumatoid arthritis, AI-measured bilateral joint space asymmetry at PIP3 and MCP3 joints on baseline hand radiographs predicted 2-year joint space narrowing with AUCs of 0.74 and 0.71, outperforming same-time high-resolution peripheral quantitative CT…

• Prospective cohort of 46 RA patients in clinical remission with normal baseline radiographs; high-resolution peripheral quantitative computed tomography (HR-pQCT) at 0, 12, and 24 months served as reference and phenotype ground truth.
• Gaussian mixture modeling stratified 17 progressors and 29 non-progressors based on 24-month HR-pQCT joint space metrics.
• Limitation: Small sample (n=46), single-center, no external validation — findings are exploratory and hypothesis-generating.

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