Mjaavatten Maria Dahl, Haugen Anne Julsrud, Helgetveit Knut, Nygaard Halvor, Sidenvall Göran, Uhlig Till, Kvien Tore Kristian
Department of Rheumatology, Diakonhjemmet Hospital, 0319 Oslo, Norway.
J Rheumatol. 2009 Jul;36(7):1401-6. doi: 10.3899/jrheum.081217. Epub 2009 Jun 1.
To investigate the distribution of joint involvement in a cohort of patients with very recent onset arthritis and describe the disease characteristics in these patients.
A very early arthritis clinic (NOR-VEAC) was established as a multicenter study. General practitioners were asked to refer patients presenting with at least 1 swollen joint of maximum 16 weeks' duration. Clinical and laboratory markers were examined.
We included 634 patients during the first 3 years, with mean (25th-75th percentile) arthritis duration of 30 (11-63) days. Monoarthritis was present in 243 (38.3%) patients, 216 (34.1%) had oligoarthritis, and 175 (27.6%) polyarthritis. Patients with polyarthritis were older, had longer duration of arthritis, and were more frequently anti-cyclic citrullinated peptide antibody and rheumatoid factor-positive. Patients in all 3 joint pattern groups (mono-/oligo-/polyarthritis) reported substantial effect on physical function, pain, and fatigue and had elevated levels of acute-phase reactants. Knee or ankle arthritis was most frequent in patients with mono- and oligoarthritis, whereas small joint involvement was most frequent in patients with polyarthritis.
Patients with recent-onset arthritis report a substantial influence on health status. Mono- and oligoarthritis are at least as frequent as polyarthritis. Polyarthritic patients more frequently exhibit features associated with a worse outcome.
调查近期发病的关节炎患者队列中关节受累的分布情况，并描述这些患者的疾病特征。
设立了一个极早期关节炎诊所（NOR-VEAC）作为一项多中心研究。要求全科医生转诊出现至少1个肿胀关节且病程最长16周的患者。对临床和实验室指标进行检查。
在最初3年中我们纳入了634例患者，关节炎平均病程（第25-75百分位数）为30（11-63）天。243例（38.3%）患者为单关节炎，216例（34.1%）为少关节炎，175例（27.6%）为多关节炎。多关节炎患者年龄更大，关节炎病程更长，抗环瓜氨酸肽抗体和类风湿因子阳性的频率更高。所有3种关节模式组（单关节炎/少关节炎/多关节炎）的患者均报告身体功能、疼痛和疲劳受到严重影响，且急性期反应物水平升高。单关节炎和少关节炎患者中膝或踝关节关节炎最为常见，而多关节炎患者中小关节受累最为常见。
近期发病的关节炎患者报告健康状况受到严重影响。单关节炎和少关节炎的发病率至少与多关节炎一样高。多关节炎患者更常表现出与较差预后相关的特征。
