A simplified twenty‐eight–joint quantitative articular index in rheumatoid arthritis

Fuchs, Howard A.; Brooks, Raye H.; Callahan, Leigh F.; Pincus, Theodore

doi:10.1002/anr.1780320504

Cited by 212 publications

(127 citation statements)

References 16 publications

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“…Prevoo et al found that weighted joint indices did not differ substantially from nonweighted joint indices in the evaluation of disease activity of RA, and recommended use of the 28-joint index based on its simplicity, validity, and reliability (10). Fuchs et al also suggested that weighted scoring system did not actually add substantially to the information derived from a joint count 868 Tanaka et al (22). However, the results obtained with weighted scoring systems of the Thompson-Kirwan and Stewart Articular Index appear to support our results, with the exception of the shoulder joint.…”

Section: Discussionsupporting

confidence: 68%

Impact of shoulder, elbow, and knee joint involvement on assessment of rheumatoid arthritis using the American College of Rheumatology Core Data Set

Tanaka¹,

Saitō²,

Kamitsuji³

et al. 2005

Arthritis & Rheumatism

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Objective. To determine the most sensitive scoring method for assessment of rheumatoid arthritis (RA) disease activity using the American College of Rheumatology Core Data Set. Methods. The subjects were 4,530 patients with RA (mean age 57.9 years, mean disease duration 12.7 years) who participated in a large observational cohort study of RA patients. The 68 joints assessed were classified into 15 joint areas, and each joint variable was categorized based on the presence or absence of swelling or pain in these areas. Multiple linear regression and analysis of variance were used to evaluate the significance of effects of these 15 joint areas on variables for assessment of RA disease activity such as patient's assessment of pain on a visual analog scale (VAS), patient's and physician's global assessment of disease activity on a VAS, HAQ (Health Assessment Questionnaire), and Japanese HAQ. Results. Although the 3 most frequently affected joints were the wrist, metacarpophalangeal joints, and proximal interphalangeal joints, the 5 joints with the largest contributions to all of the variables assessed for disease activity were the shoulder, elbow, and knee joints, followed by the wrist and ankle joints. The combination of shoulder, elbow, and knee joints accounted for approximately 70% of the contribution to all the variables, while addition of the wrist and ankle joints increased this value to approximately 90%. Conclusion. Scoring for assessment of RA disease activity would be more sensitive if separate joints such as the shoulder, elbow, knee, wrist, and ankle joints were weighted differently.

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Section: Discussionsupporting

confidence: 68%

Impact of shoulder, elbow, and knee joint involvement on assessment of rheumatoid arthritis using the American College of Rheumatology Core Data Set

Tanaka¹,

Saitō²,

Kamitsuji³

et al. 2005

Arthritis & Rheumatism

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“…This calculation was performed to simulate a standard physician formal 28-joint count, in which only normal/abnormal, rather than a graded score, is recorded (12). Physician and laboratory measures.…”

Section: Methodsmentioning

confidence: 99%

“…Means, medians, and frequencies of RADAI scores were computed for patients with each diagnosis as total scores (range 0 -48) and as the number of involved joint groups (range 0 -16), in order to simulate a physician joint count (in which only normal/abnormal rather than a graded score is recorded) (12). The proportion of patients scoring each specific joint group as painful was also computed for each diagnostic group.…”

Section: Significance and Innovationsmentioning

confidence: 99%

Patient self‐report RADAI (Rheumatoid Arthritis Disease Activity Index) joint counts on an MDHAQ (Multidimensional Health Assessment Questionnaire) in usual care of consecutive patients with rheumatic diseases other than rheumatoid arthritis

Castrejón¹,

Yazıcı²,

Pincus³

2013

Arthritis Care & Research

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Results. In patients with RA, SLE, OA, PsA, and gout, mean RADAI scores (range 0 -48) were 12.4, 6.5, 10.1, 6.7, and 2.7, respectively. The mean numbers of involved joint groups (range 0 -16) were 6.9, 3.8, 4.8, 4.5, and 1.7, respectively, and the median numbers were 6, 2, 4, 4, and 1, respectively. RADAI scores were correlated significantly with the physician global estimate, except in SLE, and at higher levels with the MDHAQ and RAPID3 scores in all diagnostic groups. Conclusion. The RADAI self-report joint counts can be used to record self-report involvement of specific joints and joint groups in patients with SLE, OA, PsA, and gout, with minimal effort on the part of the rheumatologist.

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“…'9 Furthermore, only 40-60% of the ingested nitrate appeared in urine,'9 20 which helps to explain why people taking a diet high in nitrate excrete less nitrate in the urine than they ingest. '9 (28) mm/lst h, joint count 20 (6), and early morning stiffness 4 (2) h). Tables 1 and 2 summarise the epidemiological, drug treatment, clinical, and laboratory data of each patient.…”

Section: Introductionmentioning

confidence: 94%

Urinary nitrate excretion is increased in patients with rheumatoid arthritis and reduced by prednisolone.

Stichtenoth

Fauler

Zeidler

et al. 1995

Annals of the Rheumatic Diseases

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Objectives-To determine daily production of nitric oxide (NO) measured as urinary nitrate excretion, and the effect of prednisolone in patients with rheumatoid arthritis (RA). Methods-Twenty four hour urinary nitrate was measured by gas chromatography in 10 patients with RA, before and two to four weeks after commencement of prednisolone 0 5 mg/kg body weight, and in 18 healthy controls. Results-Before the start of prednisolone treatment the urinary nitrate excretion in patients with RA was 2*7-fold greater (p < 0.001) than that in healthy volunteers.After prednisolone it decreased significantly, by 28%, at which time inflammatory activity (as indicated by C reactive protein, erythrocyte sedimentation rate, joint count, and early morning stiffness) was also reduced considerably. Despite this decrease, the urinary nitrate excretion in patients with RA remained twice that in the control group (p < 0 05). Conclusion-Our data suggest that the endogenous production ofNO is enhanced in patients with RA. Furthermore, the results indicate that, in parallel with suppression of inflammation, this increased NO synthesis could be reduced by prednisolone treatment. is readily oxidised to nitrite and nitrate,'8 which are excreted rapidly into the urine. This endogenous nitrate synthesis explains the finding, made before discovery of the NO pathway, that people taking diets low in nitrate excrete four fold more nitrate in the urine than the amount ingested in their diet. '9 Furthermore, only 40-60% of the ingested nitrate appeared in urine,'9 20 which helps to explain why people taking a diet high in nitrate excrete less nitrate in the urine than they ingest.'9 To summarise: in the absence of excess dietary nitrate intake, the major source of urinary nitrate is endogenously synthesised NO.2' 22 NO synthase activity can therefore be reliably and noninvasively assessed by measurement of urinary nitrate excretion.23 In the present study we determined urinary nitrate excretion and the effect of prednisolone in patients with RA.

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A simplified twenty‐eight–joint quantitative articular index in rheumatoid arthritis

Cited by 212 publications

References 16 publications

Impact of shoulder, elbow, and knee joint involvement on assessment of rheumatoid arthritis using the American College of Rheumatology Core Data Set

Impact of shoulder, elbow, and knee joint involvement on assessment of rheumatoid arthritis using the American College of Rheumatology Core Data Set

Patient self‐report RADAI (Rheumatoid Arthritis Disease Activity Index) joint counts on an MDHAQ (Multidimensional Health Assessment Questionnaire) in usual care of consecutive patients with rheumatic diseases other than rheumatoid arthritis

Urinary nitrate excretion is increased in patients with rheumatoid arthritis and reduced by prednisolone.

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