Rheumatoid arthritis: explanatory power of specific radiographic findings for patient clinical status.

Abstract

Radiographs of the hands and wrists of 201 patients with rheumatoid arthritis (RA) were scored for erosion, joint space narrowing, and malalignment. The explanatory power of these findings for measures of clinical status was studied with stepwise multiple linear regression analyses. Radiographic scores explained 59.2% of variation in physical joint count deformity scores, 58.5% of variation in limited motion scores, 22.5% of variation in grip strength scores, 20.5% of variation in button test scores, and 13.5% of variation for the American Rheumatism Association (ARA) Functional Class. Malalignment scores best explained variation in physical deformity, limited motion, and button test scores; joint-space-narrowing scores best explained variation in grip strength; erosion scores best explained variation in ARA Functional Class. When age, duration of disease, erythrocyte sedimentation rate, and rheumatoid factor titer were included in the regression analyses, results were similar to those without these variables. Therefore quantitative scores of specific radiographic findings are in themselves explanatory for measures of clinical status.

Measures of activity and damage in rheumatoid arthritis: Depiction of changes and prediction of mortality over five years

“…Cross-sectional data from the baseline evaluation of these patients have been presented in previous reports concerning the joint count (50,51); radiographs (34,35,50,52,53); rheumatoid factor (35); grip strength, walk time, and button time (47); and self-report questionnaire data concerning ADL difficulty (36), pain (49), and helplessness (39,40). These reports include further details concerning methods used for data collection and data management.…”

“…Hand radiographs were assessed according to a Kaye-modified Sharp scoring method (52), which includes assignment of individual scores for joint space narrowing in 14 joints, erosion in 11 joints, and malalignment in 15 joints of the hand. The total radio-graphic score is the mean of 40 scores for each hand or 80 scores per patient (the mean is used to adjust for certain joints that cannot be scored such as a PIP joint with a flexion contraction) (56).…”

“…--__ s2YEARS(52) .._....__... 3 -6 YEARS (53) Actuarial survival of 206 patients with rheumatoid arthritis over 5 years according to age, formal education, duration of disease, and American College of Rheumatology (formerly the American Rheumatism Association [ARA]) Functional Class. 8 INVOLVED JOINTS (10) ....._ .... ... 9-30 INVOLVED JOINTS (561 -----31-48 INVOLVED JOINTS (67)…”

Role of ultrasound in assessment of early rheumatoid arthritis

“…Radiographs are an important method of documenting the progression of joint damage. Over the years, several methods have been designed to score progressive joint damage 24–30 . The most widely used in recent times is the modified Sharp/Van der Heijde score 31 .…”