Pincus T, Fuchs H A, Callahan L F, Nance E P, Kaye J J
Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232-4500, USA.
J Rheumatol. 1998 Apr;25(4):636-40.
To analyze the time course of development of radiographic erosion, joint space narrowing, and malalignment in a longitudinal study of radiographs of the hands and wrists of 58 patients with rheumatoid arthritis (RA) taken over 18 years.
Among 210 consecutive patients in a reported cohort, 58 had at least one prior available radiograph 2-18 years earlier. A total of 141 hand and wrist radiographs in the 58 patients were scored for joint space narrowing, erosion, and malalignment in individual joints.
Of the 58 patients studied, all developed joint space narrowing, 56 (96.5%) developed erosions, while only 24 (41.4%) developed malalignment. In radiographs of 22 patient studied within the first 5 years of disease, joint space narrowing was seen in 17 (77.3%), erosion in 16 (72.7%), and malalignment in only 3 (13.6%). Radiographic progression was seen in all 36 patients in whom the interval between radiographs was longer than 2 years.
Joint space narrowing and erosion are seen in hand radiographs of most patients with RA seen in treatment centers within the first 5 years of disease. By contrast, malalignment develops in fewer patients, and generally only after 5 years of disease.
在一项对58例类风湿关节炎（RA）患者长达18年的手部和腕部X线片纵向研究中，分析影像学侵蚀、关节间隙变窄和排列不齐的发展时间进程。
在一个报告队列中的210例连续患者中，58例在2至18年前至少有一张先前的可用X线片。对这58例患者的总共141张手部和腕部X线片的各个关节的关节间隙变窄、侵蚀和排列不齐情况进行评分。
在研究的58例患者中，所有人都出现了关节间隙变窄，56例（96.5%）出现了侵蚀，而只有24例（41.4%）出现了排列不齐。在疾病最初5年内研究的22例患者的X线片中，17例（77.3%）出现关节间隙变窄，16例（72.7%）出现侵蚀，只有3例（13.6%）出现排列不齐。在X线片间隔时间超过2年的所有36例患者中均可见影像学进展。
在疾病的前5年内，在治疗中心就诊的大多数RA患者的手部X线片中可见关节间隙变窄和侵蚀。相比之下，出现排列不齐的患者较少，且通常在疾病5年后才出现。
