RADIOGRAPHIC CHANGES IN THE FEET OF PATIENTS WITH EARLY RHEUMATOID-ARTHRITIS

Objective. To assess the value of radiographs of the feet of patients with early rheumatoid arthritis (RA) in the evaluation of RA classific ation and outcome. Methods, Within a multicenter therapeutic trial, ba seline and 12 month radiographs of the hands, wrists, and feet of 284 patients with early RA (less than or equal to 4 years; mean 1.4; media n 0.6) were scored according to a modified Larsen-Dale method by an in dependent radiological reading committee, blinded to the treatment, cl inical, and laboratory data. Results. Thirty-two patients (11%) had on ly foot erosions at baseline, Twelve month progression in the eroded j oint count was more frequent in the patients with fool erosions than i n those without (63% CI 55 divided by 71 vs 42% CI 35 divided by 50). Conclusion. Foot radiographs facilitate the identification of patients with early erosive RA. Foot involvement is indicative of more aggress ive disease. Assessment of foot radiographs allows the most adequate t herapeutic strategy to be adopted.