Kw. Drossaers-bakker et al., Radiographic damage of large joints in long-term rheumatoid arthritis and its relation to function, RHEUMATOLOG, 39(9), 2000, pp. 998-1003
Objective. To describe the extent of radiographic damage of large joints in
long-term rheumatoid arthritis (RA) and its relationship to small joint in
volvement and physical function.
Methods. After 12 yr of follow-up, radiographs of all large joints (Larsen
large joint score 0-60) of 105 recent RA patients were assessed. Correlatio
ns were evaluated between the Larsen large joint score and radiographic dam
age of the hands and feet as measured by the van der Heijde modification of
the Sharp score (SHS) and the health assessment questionnaire (HAQ). We de
termined the relative contributions of radiographic damage of small and lar
ge joints, disease activity and psychological function to the HAQ.
Results. The median Larsen large joint score was 3. In 54% of the patients
at least one large joint was erosive. The correlation of the Larsen score w
ith the SHS and HAQ scores was 0.76 and 0.60, respectively. Disease activit
y and radiographic damage of the large joints were the major determinants o
f the HAQ score.
Conclusion. Large joint involvement after 12 yr of follow-up is extensive a
nd is associated with functional disability. Large joint involvement is clo
sely associated with small joint involvement.