Clinical joint activity: A strong predictor of structural stability in rheumatoid arthritis
Joint damage in rheumatoid arthritis (RA) is strongly predicted by clinical joint activity. However, silent advancement may take place despite of the clinical inactivity of the respective joint.
A new study has come up with the purpose of assessing the incidence of silent joint progression, but particularly on the patient level and to explore the extent of clinical inactivity as a marker for non-progression on the joint level.
The study encompassed 279 patients suffering from RA with radiographic advancement over the period of 3-5 years. Radiographic and clinical data of 22 hand/finger joints over a period of at least 3 years was acquired. Incidence of silent advancement and links of clinical joint activity and radiographic progression were examined.
Radiographic progression was shown by 120 (43%) patients in at least one of their joints without any signs of clinical activity in that particular joint. In only 7 (5.8%) patients, such silent joint progression would go unnoticed, as the remanants had other joints with clinical activity, either with (n=84; 70.0%) or without (n=29; 24.2%) associated radiographic progression. It was found that the risk of silent advancement decreased with duration of clinical activity. Silent advancement of a joint without associated deceptive clinical activity in any other joint of a patient was so uncommon, and would therefore be most likely detected by the patient’s assessment.
Hence, the findings from the study suggest that full clinical diminution is a brilliant indicator of structural stability in patients with RA, and the maintenance of this state futher diminshes the scope of advancement.