Priolo F, Bacarini L, Cammisa M, Cerase A, Ferrara R, Della Casa-Alberighi O
Department of Radiology, Catholic University, Policlinico Agostino Gemelli, Rome, Italy.
J Rheumatol. 1997 Nov;24(11):2113-8.
To assess the value of radiographs of the feet of patients with early rheumatoid arthritis (RA) in the evaluation of RA classification and outcome.
Within a multicenter therapeutic trial, baseline and 12 month radiographs of the hands, wrists, and feet of 284 patients with early RA (< or = 4 years; mean 1.4; median 0.6) were scored according to a modified Larsen-Dale method by an independent radiological reading committee, blinded to the treatment, clinical, and laboratory data.
Thirty-two patients (11%) had only foot erosions at baseline. Twelve month progression in the eroded joint count was more frequent in the patients with foot erosions than in those without (63% CI 55 divided by 71 vs 42% CI 35 divided by 50).
Foot radiographs facilitate the identification of patients with early erosive RA. Foot involvement is indicative of more aggressive disease. Assessment of foot radiographs allows the most adequate therapeutic strategy to be adopted.
评估早期类风湿关节炎（RA）患者足部X线片在RA分类及预后评估中的价值。
在一项多中心治疗试验中，由一个独立的放射学阅片委员会，按照改良的拉森-戴尔方法，对284例早期RA（≤4年；平均1.4年；中位数0.6年）患者的手部、腕部和足部的基线及12个月时的X线片进行评分，阅片者对治疗、临床及实验室数据不知情。
32例患者（11%）在基线时仅有足部侵蚀。有足部侵蚀的患者中，侵蚀关节数在12个月时的进展比无足部侵蚀的患者更常见（63%可信区间55除以71对42%可信区间35除以50）。
足部X线片有助于识别早期侵蚀性RA患者。足部受累提示疾病更具侵袭性。评估足部X线片有助于采用最恰当的治疗策略。
