Radiological Feature and Significance of Hand X-Rayin Early Rheumatoid Arthritis / 대한내과학회지

ABSTRACT

OBJECTIVES: To evaluate the disease status in relation to the radiological findings of hands using some short term indices of disease activity and laboratory tests in early rheumatoid arthritis. METHOD: 136 patients with symptoms of rheumatoid arthritis for less than 2 years were studied by means of measuring erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor, and anti-nuclear antibody. Of these, 71patients were performed the radiographies of hands at mean 1.3months after diagnosis. Also, 30 radiological films of hands were studied for measurement of intra- & inter-observer variations by well-trained rheumatologist and radiologist. All films were scored by the modified Sharps method. RESULTS: The radiological features of hands showed that the carpal bone was involved more common in the bony erosion (5.7%) and the joint space narrowing (8.8%), and the radiological progression in the interval of 24 months was positively correlated with the disease duration (p<0.05). Also, the radiological lesions and progressions appeared more severe in high disease activity, C-reactive protein (r 0.334, p 0.004) and Ritchie index (r 0.249, p 0.01) at diagnosis. On the other hand, they were correlated negatively with the age of disease onset (r -0.357, p 0.002). The Spearman correlations of inter- & intra-observer variations were significant by 0.716 and 0.775. CONCLUSION: The development of radiological lesions in early rheumatoid arthritis is closely correlated with the duration of disease. The patients with early rheumatoid arthritis who had active arthritis at the time of diagnosis showed more severe radiological progressions.