ABSTRACT
We proposed a method of regional assessment in patients with rheumatoid arthritis. The utility of this method was demonstrated by assessing drug efficacy in patients who received infliximab (n = 31) or tocilizumab (n = 6). Joints were divided into four regions: upper/large, upper/small, lower/large, and lower/small. The total joint index was calculated as follows: the sum of tender and swollen joint counts divided by the number of evaluable joints in each region. At the baseline, the total joint index of the upper/small region was the lowest and that of the lower/large region was the highest compared with other regions. The change in the total joint index from the baseline to the 30-week point (Δ) did not differ among the four regions. There were significant close relations of Δ between the upper/small and the upper/large region and between the lower/small and the lower/large region. This method allows us to focus on a specific region and to compare and contrast among them.
Subject(s)
Antibodies, Monoclonal, Humanized/therapeutic use , Antibodies, Monoclonal/therapeutic use , Antirheumatic Agents/therapeutic use , Arthritis, Rheumatoid/diagnosis , Arthritis, Rheumatoid/drug therapy , Joints/drug effects , Joints/pathology , Outcome Assessment, Health Care , Arthritis, Rheumatoid/pathology , Arthritis, Rheumatoid/physiopathology , Humans , Infliximab , Japan , Joints/physiopathology , Predictive Value of Tests , Retrospective Studies , Severity of Illness Index , Treatment OutcomeABSTRACT
OBJECTIVES: We tested the use of supraclavicular stimulation as a prognostic measure of deltoid function after cervical spondylotic radiculopathy. METHODS: Electrophysiological study consisted of supramaximally stimulating the brachial plexus and recording compound muscle action potentials (CMAPs) from the deltoid in 32 patients with unilateral weakness of 3 months or shorter duration as compared with 69 healthy subjects. RESULTS: Despite considerable individual variability and age-related reduction in amplitude and area of deltoid CMAPs, the side-to-side ratios yielded useful, reproducible values. The measures recorded initially correlated significantly with the eventual recovery of deltoid strength but, interestingly, not with the initial degree of weakness. In particular, the CMAPs greater than 50%, even in the face of severe weakness, predicted a nearly complete return of function. CONCLUSIONS: Supraclavicular stimulation provides a useful measure in monitoring deltoid weakness and predicting its recovery in patients with cervical spondylosis.
