Simon D, Kleyer A, Bui CD, et al. - This study was undertaken to investigate whether microstructural bone lesions in rheumatoid arthritis (RA) at-risk individuals are related to the spectrum of anti-modified protein antibodies (AMPA) and affect the risk to develop RA. Researchers examined cortical micro-channels (CoMiCs) as well as cortical and trabecular bone volumes by high-resolution CT in the hand joints of RA at-risk individuals. They profiled anti-modified protein antibody (AMPA) response including reactivities against citrullinated proteins (vimentin, enolase, fibrinogen) as well as carbamylated and acetylated vimentin. In RA, microstructural changes at-risk individuals are correlated with broad-spectrum autoimmunity and predict the onset of RA. This evidence strengthens the concept of structural priming of joints by autoimmunity before the onset of the inflammatory phase of the disease.