Diagnostic value of radiographs of the hands and feet in early rheumatoid arthritis - 01/01/02
Valérie Devauchelle-Pensec, Alain Saraux * , Sabine Alapetite, Danièle Colin, Paul Le Goff*Correspondence and reprints
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Résumé |
The extent to which radiographs of the hands and feet can contribute to the diagnosis of early rheumatoid arthritis (RA) has received little research attention. Yet, the workup for recent-onset inflammatory joint disease usually includes radiographs of the hands and feet. We reviewed the literature for data on the value of these radiographs for diagnosing early RA. We sought to determine whether radiographic changes in the hands and feet constitute a valid diagnostic criterion, i.e., show good discrimination, good reproducibility, and an ability to detect early disease. Furthermore, we evaluated whether the sensitivity, specificity, and positive and negative predictive values of these changes could be calculated from published data. Few cohort studies of early inflammatory joint disease have been published, and the data come mainly from studies in early RA. Among radiographic alterations described to date, erosions seem associated with the best reliability and discriminating power. Radiographic alterations are of limited sensitivity for early rheumatoid arthritis because they occur only after some time. Radiographs of the hands and feet are far easier to obtain than magnetic resonance imaging and ultrasonography, which seem promising but are still undergoing validation.
Mots clés : early arthritis ; foot radiograph ; hand radiograph ; inflammatory joint disease ; rheumatoid arthritis.
Plan
Vol 69 - N° 5
P. 434-441 - octobre 2002 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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