LONG-TERM PROGRESSION OF JOINT DAMAGE IN RHEUMATOID-ARTHRITIS
LONG-TERM PROGRESSION OF JOINT DAMAGE IN RHEUMATOID-ARTHRITIS
复制标题
DOI：
10.1136/ard.45.5.373
复制
发表时间：
1986-05-01
影响因子：
27.4
通讯作者：
POPERT, AJ
中科院分区：
文献类型：
--
作者：
SCOTT, DL;COULTON, BL;POPERT, AJ
类风湿性关节炎的关节损害是通过放射学来评估的。以前的研究没有详细研究它的长期进展。我们对50例风湿病患者在一个风湿病中心进行了10年的随访，对其周围关节损害的总体变化进行了放射学评估。分别于0、10年采用Larsen-S标准片对12组患者的周围关节进行评分。总分恶化48例(平均增加13%，最大损伤)。尽管血清阳性患者有更多的初始损害和更大的进展率，但在任何患者中都没有不同的进展模式。最初，手腕和脚的小关节受到的影响最大。在这10年中，大部分进展发生在手腕、膝盖和掌指关节。进展发生在最初正常和异常的关节中。10年后，只有16.5%的关节组没有损伤。完全破坏最常见的是手腕、膝盖和脚的小关节。手和手腕的损伤很好地反映了0年和10年的总体变化以及损伤的增加(相关系数从r=0.74到r=0.85)。这些结果表明，特定的关节参与了疾病的不同阶段。有些关节经常受累，有些则较少受累。手和手腕可以合理地描绘出损伤的整体进展情况。
Joint damage in rheumatoid arthritis is assessed radiologically. Previous studies have not examined in detail its long term progression. We evaluated the overall changes of peripheral joint damage radiologically in 50 rheumatoid patients followed up at one rheumatology center for 10 years. All peripheral joints were scored in 12 groups with Larsen''s standard films at 0 and 10 years. In 48 cases the total scored deteriorated (mean increase 13% maximum damage). There was no different pattern of progression in any of the patients, though seropositive patients had more initial damage and a greater rate of progress. The wrist and small joints of the feet were most affected initially. During the 10 years most progression occurred in the wrist, knee, and metacarpophalangeal joints. Progression occurred in both initially normal and abnormal joints. By 10 years only 16.5% joint groups showed no damage. Complete destruction was most common in the wrist, knee, and small joints of the feet. Damage to the hands and wrists gave a good indication of overall changes at 0 and 10 years and also the increase in damage (correlation coefficients were from r = 0.74 to r = 0.85). These results show that specific joints are involved in different stages of the disease. Some joints are frequently involved and some less often. The hands and the wrists give a reasonable picture of the overall progression of damage.