Limited Diagnostic and Prognostic Value of Routine Radiographs in Newly Presenting Arthritis Suspected of Rheumatoid Arthritis: A Retrospective Study
Authors' conclusion
The recommendation of conducting routine X-HF in patients with newly presenting arthritis suspected of RA might be reconsidered due to low prevalence of early erosive disease and lack of diagnostic and prognostic value.
Study context
- Population
- Patients with newly presenting arthritis suspected of rheumatoid arthritis (RA), 2016–2019, with RF and ACPA measured, RA in the differential diagnosis and routine radiographs of hands and feet (X-HF)
- Participants
- 724 patients
- Outcome
- Prevalence of one or more RA-associated erosion(s) on routine X-HF, and whether diagnostic or prognostic classification were changed by erosivity
Main finding
As reported in the abstract
Patients with RA-associated erosions: 32 of 724
4.4%
95% CI 3.1–6.2
Observational data: associations, not effects.
Further findings
Change of diagnostic classification by erosions
- Two patients
- 0.3% (95% CI 0.01-1.1)
Change of prognostic classification by erosions
- Three patients
- 0.4% (95% CI 0.1-1.3)
Prevalence of erosions in seronegative patients (subgroup)
- Significantly lower prevalence of erosions
- χ2 9.4, P = 0.002
Prevalence of erosions in patients without elevated acute phase reactants (subgroup)
- Significantly lower prevalence of erosions
- χ2 6.5, P = 0.01
Prevalence of erosions by longer symptom duration (subgroup)
- Not associated with a different prevalence of erosions
- χ2 0.4, P = 0.81
Original publication
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