Dawes P T
Br J Rheumatol. 1988;27 Suppl 1:21-36.
Radiographs are an accepted method of assessing disease severity and progression in rheumatoid arthritis. The advantages of using radiological damage as an outcome measure are that it reflects the history of the joint pathology, it can be objectively scored, radiographs provide a permanent record necessary for sequential studies and they do relate to other measures of disease outcome. However, measurement of radiological damage is fraught with methodological problems and studies to define what is the best approach have only recently been performed. There is also the problem of differentiating between radiological progression which is unavoidable due to mechanical derangement and that which is due to currently active disease. The effect of treatment on radiological damage remains controversial. A better understanding of how to use this important outcome measure should now provide rheumatologists with a more critical assessment of new therapies as well as providing a better knowledge of the disease process.
X线片是评估类风湿关节炎疾病严重程度和进展情况的一种公认方法。将放射学损伤用作结局指标的优点在于，它反映了关节病理学的病史，能够进行客观评分，X线片提供了纵向研究所需的永久性记录，并且确实与疾病结局的其他指标相关。然而，放射学损伤的测量存在诸多方法学问题，而确定最佳方法的研究直到最近才开展。此外，还存在区分因机械紊乱导致的不可避免的放射学进展与因当前活动性疾病导致的放射学进展的问题。治疗对放射学损伤的影响仍存在争议。更好地理解如何使用这一重要结局指标，现在应该能让风湿病学家对新疗法进行更严格的评估，并更好地了解疾病进程。
