There was no significant difference in 28TJC, 28SJC, PtGA, PrGA, HAQ, ESR, CRP, RF, or anti-CCP between high grade and low grade synovitis and no significant correlation between 28TJC, 28SJC, PtGA, PrGA, HAQ, ESR, CRP, RF, anti-CCP, and synovitis score (all P > 0.05). This evidence concerns the gene ESR1 and synovitis.