DESTRUCTION OF THE FIRST CARPOMETACARPAL JOINT BEHAVES DIFFERENTLY FROM THAT OF THE ENTIRE CARPUS IN RHEUMATOID-ARTHRITIS - A 20-YEAR FOLLOW-UP-STUDY

The aim of our study was to examine the radiographic changes of the wr ist and the first carpometacarpal (CMC I) joints in rheumatoid arthrit is (RA) occurring over 20 years. The wrists of 83 RF positive RA patie nts with recent (less than or equal to 6 months) arthritis were evalua ted radiographically at onset, at 1, 3, 8, and 15 years and of 68 pati ents 20 years from entry. In hands where wrist fusion was performed, f ollow-up continued until the arthrodesis. Larsen grading for the wrist joints and modified grades for the ipsilateral CMC I joints were comp ared. Larsen grades of both wrists differed highly significantly (p < 0.001) from the grades of the ipsilateral CMC I joints after 3 years a nd up to end of the study. In conclusion destruction of the CMC I does not proceed uniformly with destruction of the entire carpus and it wo uld be beneficial to classify it separately.