Several factors were significantly associated with these early structural lesions among RA patients: anti-CCP antibody positivity (P = 0.0002), gender (females), age (P = 0.04), increased CRP level or ESR (P = 0.016 and P = 0.005, respectively), and DKK-1 and IL-6 levels (P = 0.0001 and P < 0.0001, respectively). The gene discussed is DKK1; the disease is rheumatoid arthritis.