A synovectomy trial and the history of early knee synovitis in rheumatoid arthritis. A multicentre study.
The results of a randomized synovectomy trial are reported and the history of early knee synovitis in 121 patients with rheumatoid arthritis is described. Conservative treatment (rest in splints, non-steroidal anti-inflammatory drugs and gold or an anti-malaria agent) for 4-5 months led to improvement in 81 of the 121 patients with early knee synovitis. In one-third of these 81 patients, the improvement continued, according to their own and the doctor's opinion, during 5 years of follow-up. Ten of the 22 patients who fulfilled the criteria for the synovectomy trial were operated upon. They showed improvement for 4 years. Over the 5-year period, two-thirds of the group were constantly seropositive or seronegative and in the other third the serology varied, but such that at each assessment 50% of the group were seropositive. Radiologically, all of the patients showed deterioration. The surgical group deteriorated more slowly for the first 2-3 years, but then showed the same pattern as the other groups. The disappearance of the clinical features of synovitis does not mean that radiological deterioration has ceased.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D005069:Evaluation Studies as Topic; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011859:Radiography; D012699:Serology; D000074402:Synovectomy; D013585:Synovitis / Q000503:physiopathology*; D013997:Time Factors