Source
Department of Rheumatology, Kivelä Hospital, Helsinki, Finland.
Abstract
OBJECTIVE:
To assess the radiographic criterion in the 1987 revised criteria for the classification of rheumatoid arthritis (RA), in patients with early RA.
METHODS:
The diagnostic value of radiologic changes in the hands was compared with that of radiologic changes in the feet, in a prospective study of 78 patients with early definite or classic RA (symptoms for less than or equal to 12 months) according to the 1958 criteria.
RESULTS:
At entry, 23% of the patients had erosions only in metatarsophalangeal (MTP) joints, 6% only in hands, and 5% both in hands and in feet. After 2 years of followup, 29% of the patients had only MTP joint erosions and 3% had only hand erosions. At study entry, the level of clinical activity in patients with erosions in the feet only was lower than that in other patients, and 44% of these patients would not have been diagnosed as having RA by the 1987 criteria.
CONCLUSION:
In early RA, radiographic changes in the feet seem to be a more sensitive criterion than radiographic changes in the hands. Therefore, addition of radiographic evaluation of the feet to the revised criteria may improve the classification of recent-onset RA.