Methods of scoring the progression of radiologic changes in rheumatoid arthritis. Correlation of radiologic, clinical and laboratory abnormalities

Authors

  • John T. Sharp MD,

    Corresponding author
    1. Professor of Medicine, Chief, Rheumatic Disease Section, Baylor College of Medicine, Houston, Tex 77025
    • Professor of Medicine, Chief, Rheumatic Disease Section, Baylor College of Medicine, Houston, Tex 77025
    Search for more papers by this author
  • Martin D. Lidsky MD,

    1. Associate Professor of Medicine, Baylor College of Medicine, and Chief of Rheumatology, Veterans Administration Hospital, Houston, Tex 77031
    Search for more papers by this author
  • Lois C. Collins MD,

    1. Formerly Professor of Radiology, Baylor College of Medicine and Radiologist, Ben Taub General Hospital, Houston
    Current affiliation:
    1. Presently Clinical Associate Professor, University of Texas, Graduate School of Biomedical Sciences, and Radiologist, Rosewood General Hospital, 9200 Westheimer, Houston, Tex 77042
    Search for more papers by this author
  • June Moreland MA

    1. Research Assistant, Department of Medicine, Baylor College of Medicine, Houston, Tex 77025
    Search for more papers by this author

Abstract

Methods of scoring osseous defects and joint space narrowing in the hands and wrists of patients with definite or classical rheumatoid arthritis were devised. The usefulness of the scores was tested in a group of 90 patients who had one or more sets of X-ray films of the hands and wrists 36 months or more after onset of illness. Correlations were found between the extent of radiographic abnormalities or the rate of progression of radiographic changes and the age at onset, hand and wrist deformities, preceding physical signs of inflammation in the joints of the hands and wrists, hand function as measured by fist formation, the early appearance of subcutaneous nodules, and the titer of anti-IgG. Among black patients the extent of elevation of γ-globulins was associated with roentgenographic changes. The correlations between the scores of radiologic abnormalities and the clinical and laboratory manifestations of rheumatoid arthritis establish the value of the described methods of assessing the roentgenographic changes and indicate the usefulness of these methods in evaluating the effect of therapy in this disease.

Ancillary