BMJ 1996;313:1398 (30 November)

Letters

Algorithm to predict radiological erosions in early rheumatoid arthritis

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EDITOR,--Paul Brennan and colleagues found that rheumatoid factor, disease lasting longer than three months, the involvement of at least two large joints, and male sex were significant predictors of radiological erosions in patients with arthritis in primary care.1 The first two findings are consistent with, but the latter two conflict with, previous data. Is this important, and why has it arisen?

Entry criteria--The authors used the American College of Rheumatology's criteria for rheumatoid arthritis. These criteria, however, were not devised or intended to be used for early presentation in hospital, let alone in the community.

Study design--Baseline observations were correlated with radiological findings at roughly one year; thus an existing erosion (which in a community setting may be asymptomatic and unrelated to disease2) was equated with a new erosion. Radiological examination was also performed a variable time after the start of drug treatment (which . . . [Full text of this article]


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Relevant Article

A simple algorithm to predict the development of radiological erosions in patients with early rheumatoid arthritis: prospective cohort study
Paul Brennan, Beverley Harrison, Elizabeth Barrett, Kuntal Chakravarty, David Scott, Alan Silman, and Deborah Symmons
BMJ 1996 313: 471-476. [Abstract] [Full Text]

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