Logo of annrheumdAnnals of the Rheumatic DiseasesVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
Ann Rheum Dis. 1984 Feb; 43(1): 8–17.
PMCID: PMC1001208

Progression of radiological changes in rheumatoid arthritis.


A prospective study over one year of patients who had active rheumatoid arthritis discovered 64 who had received treatment for an adequate time with second-line drugs. In these patients there was evidence of continuing joint destruction as shown by radiological progression. During the year there were highly significant correlations between improvements in clinical and laboratory measurements, but neither group of tests was related to the degree of radiological change. However, in the second 6 months of treatment there was evidence that radiological progression was reduced. In a second prospective study of 88 patients with rheumatoid arthritis given prolonged, intensive therapy with second-line drugs and followed up for 10 years two-thirds showed radiological progression. However, the number of joints damaged per year fell significantly during the study period. There was a divergence between deterioration in radiological features and improvements in the ESR and functional capacity, though patients with a persistently low ESR had less radiological progression. These studies provide evidence that treatment may be associated with a reduced rate of radiological progression but suggest that changes in radiological progression and clinical and laboratory measurements may result from different mechanisms.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.3M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Wright V, Amos R. Do drugs change the course of rheumatoid arthritis? Br Med J. 1980 Apr 5;280(6219):964–966. [PMC free article] [PubMed]
  • Sharp JT, Lidsky MD, Collins LC, Moreland J. Methods of scoring the progression of radiologic changes in rheumatoid arthritis. Correlation of radiologic, clinical and laboratory abnormalities. Arthritis Rheum. 1971 Nov-Dec;14(6):706–720. [PubMed]
  • Larsen A. Radiological grading of rheumatoid arthritis. An interobserver study. Scand J Rheumatol. 1973;2(3):136–138. [PubMed]
  • Smith DW, Bluhm GB. Rater reliability in reading PA films of hands for bone and cartilage changes in rheumatoid arthritis. Eur J Rheumatol Inflamm. 1982;5(2):198–205. [PubMed]
  • McConkey B, Crockson RA, Crockson AP. The assessment of rheumatoid arthritis. A study based on measurements of the serum acute-phase reactants. Q J Med. 1972 Apr;41(162):115–125. [PubMed]
  • McConkey B, Crockson RA, Crockson AP, Wilkinson AR. The effects of some anti-inflammatory drugs on the acute-phase proteins in rheumatoid arthritis. Q J Med. 1973 Oct;42(168):785–791. [PubMed]
  • McConkey B, Davies P, Crockson RA, Crockson AP, Butler M, Constable TJ. Dapsone in rheumatoid arthritis. Rheumatol Rehabil. 1976 Aug;15(3):230–234. [PubMed]
  • McConkey B. New drugs for inflammation - a clinical viewpoint for their assessment. Agents Actions. 1976 Sep;6(5):593–595. [PubMed]
  • Amos RS, Crockson RA, Crockson AP, Walsh L, McConkey B. Rheumatoid arthritis: C-reactive protein and erythrocyte sedimentation rate during initial treatment. Br Med J. 1978 May 27;1(6124):1396–1396. [PMC free article] [PubMed]
  • McConkey B, Davies P, Crockson RA, Crockson AP, Butler M, Constable TJ, Amos RS. Effects of gold, dapsone, and prednisone on serum C-reactive protein and haptoglobin and the erythrocyte sedimentation rate in rheumatoid arthritis. Ann Rheum Dis. 1979 Apr;38(2):141–144. [PMC free article] [PubMed]
  • Sigler JW, Bluhm GB, Duncan H, Sharp JT, Ensign DC, McCrum WR. Gold salts in the treatment of rheumatoid arthritis. A double-blind study. Ann Intern Med. 1974 Jan;80(1):21–26. [PubMed]
  • Shiokawa Y, Horiuchi Y, Honma M, Kageyama T, Okada T, Azuma T. Clinical evaluation of D-penicillamine by multicentric double-blind comparative study in chronic rheumatoid arthritis. Arthritis Rheum. 1977 Nov-Dec;20(8):1464–1472. [PubMed]
  • Amos RS, Constable TJ, Crockson RA, Crockson AP, McConkey B. Rheumatoid arthritis: relation of serum C-reactive protein and erythrocyte sedimentation rates to radiographic changes. Br Med J. 1977 Jan 22;1(6055):195–197. [PMC free article] [PubMed]
  • Ritchie DM, Boyle JA, McInnes JM, Jasani MK, Dalakos TG, Grieveson P, Buchanan WW. Clinical studies with an articular index for the assessment of joint tenderness in patients with rheumatoid arthritis. Q J Med. 1968 Jul;37(147):393–406. [PubMed]
  • McConkey B, Amos RS, Billingham ME, Constable TJ, Crockson RA, Crockson AP, Forster PJ. Rheumatoid arthritis: effects of a new agent (ICI 55 897) on serum acute phase proteins and the erythrocyte sedimentation rate. Ann Rheum Dis. 1980 Feb;39(1):18–21. [PMC free article] [PubMed]
  • Weisman MH, Hannifin DM. Management of rheumatoid arthritis with oral gold. Arthritis Rheum. 1979 Aug;22(8):922–925. [PubMed]
  • Larsen A, Dale K, Eek M. Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference films. Acta Radiol Diagn (Stockh) 1977 Jul;18(4):481–491. [PubMed]
  • Brook A, Corbett M. Radiographic changes in early rheumatoid disease. Ann Rheum Dis. 1977 Feb;36(1):71–73. [PMC free article] [PubMed]
  • Rothermich NO, Philips VK, Bergen W, Thomas MH. Chrysotherapy. A prospective study. Arthritis Rheum. 1976 Nov-Dec;19(6):1321–1327. [PubMed]
  • Kean WF, Anastassiades TP. Long term chrysotherapy: incidence of toxicity and efficacy during sequential time periods. Arthritis Rheum. 1979 May;22(5):495–501. [PubMed]
  • Hill HF. Penicillamine in rheumatoid arthritis: adverse effects. Scand J Rheumatol Suppl. 1979;(28):94–99. [PubMed]
  • Rothermich NO, Philips VK, Bergen W, Thomas MH. Followup study of chrysotherapy. Arthritis Rheum. 1979 Apr;22(4):423–423. [PubMed]
  • Rothermich NO, Thomas MH, Phillips VK, Bergen W. Clinical trial of penicillamine in rheumatoid arthritis. Arthritis Rheum. 1981 Dec;24(12):1473–1478. [PubMed]
  • Luukkainen R, Kajander A, Isomäki H. Effect of gold on progression of erosions in rheumatoid arthritis. Better results with early treatment. Scand J Rheumatol. 1977;6(3):189–192. [PubMed]
  • Luukkainen R, Isomäki H, Kajander A. Effect of gold treatment on the progression of erosions in RA patients. Scand J Rheumatol. 1977;6(2):123–127. [PubMed]
  • KULKA JP, BOCKING D, ROPES MW, BAUER W. Early joint lesions of rheumatoid arthritis; report of eight cases, with knee biopsies of lesions of less than one year's duration. AMA Arch Pathol. 1955 Feb;59(2):129–150. [PubMed]
  • Moberg E, Wassen E, Kjellberg SR, Zettergren L, Scheller S, Aschan W. The early pathologic changes in rheumatoid arthritis. Acta Chir Scand Suppl. 1966;357:142–147. [PubMed]
  • Evanson JM, Jeffrey JJ, Krane SM. Studies on collagenase from rheumatoid synovium in tissue culture. J Clin Invest. 1968 Dec;47(12):2639–2651. [PMC free article] [PubMed]
  • Woolley DE, Crossley MJ, Evanson JM. Collagenase at sites of cartilage erosion in the rheumatoid joint. Arthritis Rheum. 1977 Jul-Aug;20(6):1231–1239. [PubMed]
  • Scott DL, Wainwright AC, Walton KW, Williamson N. Significance of fibronectin in rheumatoid arthritis and osteoarthrosis. Ann Rheum Dis. 1981 Apr;40(2):142–153. [PMC free article] [PubMed]
  • Scott DL, Delamere JP, Walton KW. The distribution of fibronectin in the pannus in rheumatoid arthritis. Br J Exp Pathol. 1981 Aug;62(4):362–368. [PMC free article] [PubMed]
  • Aalto M, Kulonen E. Inhibition of protein synthesis in tendon cells by extracts from experimental granulation tissue. FEBS Lett. 1974 Dec 1;49(1):70–72. [PubMed]
  • Aalto M, Kulonen E. Fractionation of connective-tissue-activating factors from the culture medium of silica-treated macrophages. Acta Pathol Microbiol Scand C. 1979 Jun;87C(3):241–250. [PubMed]
  • Aalto M, Turakainen H, Kulonen E. Effect of SiO2-liberated macrophage factor on protein synthesis in connective tissue in vitro. Scand J Clin Lab Invest. 1979 May;39(3):205–213. [PubMed]
  • Kulonen E, Potila M. Macrophages and the synthesis of connective tissue components. Acta Pathol Microbiol Scand C. 1980 Feb;88(1):7–13. [PubMed]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Group


Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


  • Cited in Books
    Cited in Books
    PubMed Central articles cited in books
  • MedGen
    Related information in MedGen
  • PubMed
    PubMed citations for these articles
  • Substance
    PubChem Substance links

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...