Document Detail

Radiographic measures to assess patients with rheumatoid arthritis: advantages and limitations.
MedLine Citation:
PMID:  19962616     Owner:  NLM     Status:  MEDLINE    
Radiographs present several attractive features for the assessment and monitoring of patients with rheumatoid arthritis (RA). Radiographic erosions are the closest to a pathognomonic sign in RA. Radiographs provide a permanent record of permanent damage. Excellent quantitative scoring systems have been developed by Larsen, Sharp, van der Heijde, Genant, Rau, and others. However, quantitative radiographic scoring is used only in research studies and is not included in usual treatment. Furthermore, magnetic resonance imaging and ultrasonography may be more sensitive than radiography in detecting abnormalities. Moreover, treatment of patients with RA should be initiated before evidence of damage. Reports that biologic therapy is superior to methotrexate in preventing radiographic progression are accurate for groups of patients, although methotrexate and other disease-modifying antirheumatic drugs control inflammation in 70% to 80% of patients and most patients present no radiographic progression with methotrexate. Radiographic findings are also much less significant and functional measures are far more significant in the prediction of severe outcomes of RA, including costs and mortality. Whereas prevention of radiographic progression is certainly desirable, it appears that prevention of functional disability is far more important for successful patient outcomes.
Yusuf Yazici; Tuulikki Sokka; Theodore Pincus
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Rheumatic diseases clinics of North America     Volume:  35     ISSN:  1558-3163     ISO Abbreviation:  Rheum. Dis. Clin. North Am.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-12-07     Completed Date:  2010-02-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8708093     Medline TA:  Rheum Dis Clin North Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  723-9, vi     Citation Subset:  IM    
Division of Rheumatology, Department of Medicine, New York University School of Medicine and New York University Hospital for Joint Diseases, Room 1608, 301 East 17th Street, New York, NY 10003, USA.
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MeSH Terms
Antirheumatic Agents / therapeutic use*
Arthritis, Rheumatoid / drug therapy*,  radiography*
Arthrography / methods*
Drug Monitoring*
Reg. No./Substance:
0/Antirheumatic Agents

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