Ability of hand radiographs to predict a further diagnosis of rheumatoid arthritis in patients with early arthritis.
J Rheumatol
; 28(12): 2603-7, 2001 Dec.
Article
em En
| MEDLINE
| ID: mdl-11764204
ABSTRACT
OBJECTIVE:
To evaluate the ability of hand radiographs collected at study inclusion to predict a diagnosis of rheumatoid arthritis (RA) 2 years later, in a cohort of patients with early arthritis.METHODS:
We evaluated 270 patients with arthritis of less than one year duration. At the first visit, all patients underwent a standardized evaluation including laboratory tests and radiographs. Followup was 30+/-11.3 mo. The hand radiographs were read by observers blinded to patient data who looked for item 7 of the 1987 ACR criteria for RA and used Sharp's method to score erosions and joint space narrowing.RESULTS:
The kappa coefficient for ACR item 7 was < 0.65 for bony decalcification and > 0.8 for erosions. Intra and interobserver correlation coefficients for Sharp score ranged from 0.90 to 0.95. The "erosion" component of ACR item 7 was more specific than the full item 7 (96% versus 87.5%; p = 0.02). Sharp erosion score was not better than the erosion component of item 7 (sensitivity 17%; specificity 96%).CONCLUSION:
Regardless of the criterion used, hand radiographs were of limited value to predict which patients would be considered as having RA 2 years later. Diagnostic performance was similar for the "erosions" component of the 1987 ACR item 7 and for Sharp erosion score. The full 1987 ACR item 7 (erosions or bony decalcification) performed less well.
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Base de dados:
MEDLINE
Assunto principal:
Artrite Reumatoide
/
Mãos
Idioma:
En
Ano de publicação:
2001
Tipo de documento:
Article