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Reply to Determinants of Early Morning Stiffness in Rheumatoid Arthritis.

We are grateful for the interest in our manuscript describing synovial histology features that associate with patient reports of morning stiffness in rheumatoid arthritis1 . Jain et al raise an important point; not all joints in a patient with rheumatoid arthritis are affected equally at any given time, making it challenging to associate studies of synovium from only one joint with assessments of global patient symptoms. We had discovered that morning stiffness duration was associated with the presence of fibrin and neutrophils in synovium, however, neither of the questions used in this analysis focus on any particular joint and it is likely that joints other than the arthroplasty joint influenced patient responses.