Sharp J T, Wolfe F, Mitchell D M, Bloch D A
University of Colorado School of Medicine, Denver.
Arthritis Rheum. 1991 Jun;34(6):660-8. doi: 10.1002/art.1780340606.
Erosions and cartilage destruction are nearly universal features in peripheral joints that have been chronically affected by rheumatoid arthritis. Scoring methods to measure the extent of these abnormalities in hands and wrists have been developed and have been thoroughly tested in several studies to establish their reproducibility. In this study, we utilized one of these scoring methods to examine the progression of radiologic damage as related to duration of disease. Two hundred ninety-two patients from 3 different participating centers in the Arthritis, Rheumatism, and Aging Medical Information System were included. Six hundred fifty films of the hands and wrists, obtained from 210 patients, were scored for erosions and joint space narrowing. The average annual rate of progression of the total radiologic score, which sums erosion and joint space abnormalities and has a maximum possible score of 314, was approximately 4 units per year over the first 25 years after onset; this progression was more rapid in the earlier years of disease and slightly slower in the later years. Data were insufficient to accurately determine the progression rate in disease of more than 25 years duration.
糜烂和软骨破坏几乎是类风湿关节炎长期累及的外周关节的普遍特征。已开发出用于测量手部和腕部这些异常程度的评分方法，并在多项研究中进行了充分测试以确定其可重复性。在本研究中，我们采用其中一种评分方法来检查与疾病持续时间相关的放射学损伤进展情况。纳入了来自关节炎、风湿病和衰老医学信息系统3个不同参与中心的292例患者。对从210例患者获得的650张手部和腕部X线片进行糜烂和关节间隙变窄评分。总放射学评分（将糜烂和关节间隙异常相加，最高可能评分为314分）的平均年进展率在发病后的前25年约为每年4分；这种进展在疾病早期较快，在后期稍慢。数据不足以准确确定病程超过25年的疾病进展率。
