ABSTRACT
OBJECTIVE: To investigate the clinical usefulness of serial measurement of erythrocyte sediment rate(ESR) and C-reactive protein(CRP) for monitoring the radiological progression in early rheumatoid arthritis(RA). METHODS: Thirty one patients with RA according to the 1987 ACR criteria, with joint symptoms for less than one year, and who had not previously received disease modifying antirheumatic drugs(DMARDs) were assessed from Oct. 1994 to Aug. 1998 in retrospective study. Area under curve(AUC) of ESR and CRP were calculated in these patients. Joing damage in the hands was assessed by modified Sharp's method. RESULTS: Male to female ratio was 1: 3.4. Median age of this group was 45.8+/-13.2 years. Patients who had positive rheumatoid factor were 82%. Mean duration until first visit was 271.9+/-145.8 days. At the first clinic visit, mean ESR and CRP were 50mm/hr and 2.0mg/dL. Mean erosions and joint space narrowing score by modified Sharp's method were 55.2 and 12.4, respectively. Correlation analysis showed that ESR AUC and CRP AUC were significantly associated with radiologic progression. CONCLUSIONS: Elevated over-time ESR and CRP provide a convenient short term correlation with radiologic outcome(i.e. erosions). Elevated over-time ESR and CRP can be used as a guide for therapy.