Comparison of the Rau method and the Larsen method in the evaluation of radiographic progression in early rheumatoid arthritis.
OBJECTIVE
To investigate the usefulness of the radiographic scoring method proposed by Rau, et al for evaluation of joint damage in patients with early rheumatoid arthritis (RA).


METHODS
Radiographs of hands and feet of 30 prospectively observed patients with early RA were assessed by the Rau method, the Larsen method, and count of erosive joints. The standardized response mean (SRM) was used to estimate the sensitivity to change of each method of assessment.


RESULTS
Although the Rau method evaluates only the amount of bony erosion, nearly equivalent radiographic progression was observed with the Rau and the Larsen methods. Radiographic changes in the first year were sensitively identified by all 3 methods (SRM for Rau method 0.83, Larsen method 0.88, and count of erosive joints 0.84). However, in the period from 2 to 6 years after entry into the study, sensitivity to change was maintained with use of the Rau (SRM 1.38) and Larsen (SRM 0.95) methods, but not by count of erosive joints (SRM 0.49). While an apparent ceiling effect was observed after 2 years in count of erosive joints, no ceiling effects were noted for the Rau and Larsen methods.


CONCLUSIONS
Our study showed that the usefulness of the Rau method is equivalent to the Larsen method in clinical assessment of radiographic progression in early RA.
Tanaka
Eiichi
E
Institute of Rheumatology, Tokyo Women's Medical University, Japan. e-tanaka@tkg.att.ne.jp
Yamanaka
Hisashi
H
Matsuda
Yuko
Y
Urano
Wako
W
Nakajima
Hiroshi
H
Taniguchi
Atsuo
A
Saito
Terunobu
T
Kamatani
Naoyuki
N
D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001175:Arthrography / Q000379:methods*; D018450:Disease Progression; D005260:Female; D005528:Foot / Q000000981:diagnostic imaging; D006225:Hand / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012219:Rheumatology / Q000379:methods*; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index