van der Heijde D M
Department of Rheumatology, University Hospital Maastricht, The Netherlands.
Br J Rheumatol. 1995 Nov;34 Suppl 2:74-8.
The development of changes on X-rays in patients with rheumatoid arthritis (RA), as described in the literature, is presented. Prospective studies on patients with early disease show that approximately 75% of the patients have joint erosions. The majority of patients develop the first erosions during the first 2 yr of the disease. The rate of progression, expressed as newly eroded joints or increase in radiographic damage, is highest during the early years of the disease. Joints in the feet erode earlier than those in the hands. Moreover, more joints are affected in the feet than in the hands. Exact data on the involvement of large joints are scarce, but the progression of RA in small and large joints correlates well. Over half of the patients develop an involvement of the cervical spine during the first 10 yr of the disease. The percentage of patients with cervical subluxation increases steeply with disease duration.
本文介绍了类风湿性关节炎（RA）患者X线变化的发展情况，正如文献中所描述的那样。对早期疾病患者的前瞻性研究表明，约75%的患者存在关节侵蚀。大多数患者在疾病的头两年出现首次侵蚀。以新出现侵蚀的关节或影像学损伤增加来表示的进展速度，在疾病早期最高。足部关节比手部关节更早受到侵蚀。此外，足部受累关节比手部更多。关于大关节受累的确切数据很少，但RA在小关节和大关节中的进展相关性良好。超过一半的患者在疾病的头10年出现颈椎受累。颈椎半脱位患者的百分比随疾病持续时间急剧增加。
