title: Frequency of radiologic procedures in patients with rheumatoid arthritis.
abstract: BACKGROUND
  Patients with rheumatoid arthritis (RA) undergo radiologic investigations for disease and comorbidity evaluation. The actual use of radiologic imaging in RA is unknown.
  
  
  METHODS
  Using the Rochester Epidemiology Project medical record linkage system, adult patients from previously assembled population-based cohorts of Olmsted County, Minnesota, residents who fulfilled the 1987 American College of Rheumatology criteria for RA in 1988 to 2007 and comparator subjects without RA of similar age and gender were studied. Data on all radiologic procedures performed were collected.
  
  
  RESULTS
  The study included 650 patients with RA and 650 patients without RA. Patients with RA had significantly more radiographs of the chest (rate ratio [RR], 1.33; 95% confidence interval [CI], 1.28-31.38), upper extremity (RR, 2.97; 95% CI, 2.80-83.17), lower extremity (RR, 2.05; 95% CI, 1.94-102.16), spine (RR, 1.46; 95% CI, 1.35-41.59), and hip, pelvis, or sacroiliac joints (RR, 1.14; 95% CI, 1.03-11.26), as well as bone radionuclide (RR, 1.90; 95% CI, 1.50-52.44) and dual-energy x-ray absorptiometry imaging (RR, 1.77; 95% CI, 1.59-61.98) compared with patients without RA. Among patients with RA, having a positive rheumatoid factor was associated with an increased likelihood of undergoing radiologic procedures (RR, 1.05; 95% CI, 1.02-11.07). Women with RA underwent more imaging procedures than men (RR, 1.20; 95% CI, 1.16-21.23).
  
  
  CONCLUSIONS
  Patients with RA undergo more radiologic procedures than patients without RA. Among patients with RA, women and patients with a positive rheumatoid factor have more radiologic procedures. The utilization of radiography is likely a reflection of overall disease burden. Despite some guidelines, routine hand wrist radiographs were not obtained with regularity; "overuse" is unlikely.
authors.affiliation: From the *Department of Medicine; †Division of Rheumatology; ‡Division of Biostatistics, Department of Health Sciences Research; and §Division of Epidemiology, Department of Health Sciences Research.
authors.forename: Marcia
authors.initials: M
authors.lastname: Venegas-Pont
authors.forename: John M
authors.initials: JM
authors.lastname: Davis
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Crowson
authors.forename: Sherine E
authors.initials: SE
authors.lastname: Gabriel
authors.forename: Eric L
authors.initials: EL
authors.lastname: Matteson
mesh_terms: D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging*; D001175:Arthrography / Q000706:statistics & numerical data*; D017281:Cost of Illness; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010361:Patients; D011859:Radiography / Q000706:statistics & numerical data*; D012217:Rheumatoid Factor / Q000097:blood; D012737:Sex Factors; D013997:Time Factors
chemical_list: D012217:Rheumatoid Factor