title: Radiographic study on the pattern of wrist joint destruction in rheumatoid arthritis.
abstract: When planning therapy for rheumatoid arthritis (RA) in the wrist joint, knowing the pattern of joint destruction is important. There were a few studies using the Larsen and modified Larsen method to evaluate RA wrist joint destruction. However, these methods are inadequate for thoroughly assessing the severity of joint destruction because joint bone erosion and joint space narrowing could not be evaluated individually in these methods. To clarify the pattern of RA wrist joint destruction in the different zones of the wrist, we conducted a large-scale radiographic study. We modified the van der Heijde/Sharp method to assess radiographic images. Subjects were 191 RA patients (22 men and 169 women; mean age 57.0 years) who were examined at our center between 2001 and 2003 and underwent plain X-ray of both wrist joints (n = 382). Using X-ray images of the wrist joint, classification was performed based on the severity of wrist joint surface bone erosion and joint space narrowing at different zones, and the results were statistically analyzed. The results showed that joint space narrowing in the midcarpal joint (MCJ) advanced faster than in the radiocarpal joint (RCJ). Conversely, bone erosion in the RCJ advanced faster than in the MCJ. In X-ray diagnosis of RA wrist joint disorders, knowing the pattern of destruction is useful for assessing the presence or absence of early joint destruction and in planning therapy.
authors.affiliation: Department of Orthopaedic Surgery, Osaka University, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan. kitamura@tb3.so-net.ne.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Kitamura
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Murase
authors.forename: Jun
authors.initials: J
authors.lastname: Hashimoto
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tomita
authors.forename: Sayuri
authors.initials: S
authors.lastname: Arimitsu
authors.forename: Hideki
authors.initials: H
authors.lastname: Yoshikawa
authors.forename: Kazuomi
authors.initials: K
authors.lastname: Sugamoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012720:Severity of Illness Index; D014955:Wrist Joint / Q000000981:diagnostic imaging* / Q000473:pathology*