Bentin J
Clinique de Rhumatologie, C.H.U. Brugmann, Bruxelles.
Rev Med Brux. 2007 Sep;28(4):295-300.
The rheumatoid arthritis (RA) diagnosis is based on the ARA criteria, even though the radiological joint erosions are often a requirement to make a definite diagnosis. The early rheumatoid arthritis (ERA) concept was thought of following the poor therapeutic response of the established RA. The "window of opportunity" is defined as a time frame in the early phase of the disease in which the therapeutic response is favoured, and thus giving a real chance to modify the course and the prognosis of RA. To achieve such a goal, new imaging modalities have been developed (MRI and Musculoskeletal ultrasonography--MSU), together with new serologic, inflammatory markers, genetic tests and taking into account the environmental impact (such as tobacco smokers). Such an issue can be achieved with a tight collaboration between the primary care physician and the rheumatology speciality care.
类风湿关节炎(RA)的诊断基于美国风湿病学会(ARA)标准,尽管放射学关节侵蚀通常是做出明确诊断的必要条件。早期类风湿关节炎(ERA)的概念是在已确诊的RA治疗反应不佳之后提出的。“机会窗”被定义为疾病早期的一个时间段,在此期间治疗反应良好,从而真正有机会改变RA的病程和预后。为实现这一目标,已开发出新的成像方式(磁共振成像和肌肉骨骼超声检查——MSU),以及新的血清学、炎症标志物、基因检测,并考虑到环境影响(如吸烟者)。通过初级保健医生和风湿病专科护理之间的紧密合作可以实现这一目标。