title: Serological and Progression Differences of Joint Destruction in the Wrist and the Feet in Rheumatoid Arthritis - A Cross-Sectional Cohort Study.
abstract: OBJECTIVE
  To investigate clinical and radiological differences between joint destruction in the wrist and the feet in patients with RA.
  
  
  METHODS
  A cross-sectional clinical study was conducted in an RA cohort at a single institution. Clinical data included age, sex and duration of disease. Laboratory data included sero-positivity for anti-cyclic citrullinated peptide (CCP) antibody and RF. Radiological measurements included Larsen grades and the modified Sharp/van der Heijde method (SHS) for the hands/wrists and the feet. Statistical analyses were performed using the Kruskal-Wallis H-test, a dummy variable linear regression model and multivariate logistic regression analysis with 95% confidence interval and odds ratios.
  
  
  RESULTS
  A total of 405 patients were enrolled, and 314 patients were analysed in this study. The duration of disease in the foot-dominant group was significantly less than that in the wrist-dominant group. When patients were subdivided by duration of disease, the Larsen grade of the feet was significantly higher than that of the wrist in the first quadrant subgroup, but this was reversed with increasing duration of disease. Anti-CCP status was a significant predictive factor for joint destruction in the wrist but not in the feet, while RF status was not predictive in either the wrist or the feet.
  
  
  CONCLUSIONS
  Joint destruction in the feet started earlier than in the wrist, but the latter progresses faster with increasing duration of disease. Anti-CCP status predicts joint destruction in the wrist better than in the feet.
authors: Department of Orthopedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors: Yosuke
authors: Y
authors: Hamamoto
authors: Department of Orthopedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors: Hiromu
authors: H
authors: Ito
authors: Department of Orthopedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan; Department of the Control for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors: Moritoshi
authors: M
authors: Furu
authors: Department of the Control for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors: Motomu
authors: M
authors: Hashimoto
authors: Department of the Control for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors: Takao
authors: T
authors: Fujii
authors: Department of Orthopedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan; Department of the Control for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors: Masahiro
authors: M
authors: Ishikawa
authors: Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors: Noriyuki
authors: N
authors: Yamakawa
authors: Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors: Chikashi
authors: C
authors: Terao
authors: Department of Orthopedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors: Masayuki
authors: M
authors: Azukizawa
authors: Department of Orthopedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors: Takahiro
authors: T
authors: Iwata
authors: Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors: Tsuneyo
authors: T
authors: Mimori
authors: Department of Orthopedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors: Shuichi
authors: S
authors: Matsuda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D005260:Female; D033023:Foot Joints / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D014955:Wrist Joint / Q000000981:diagnostic imaging*