DO GOLD RINGS PROTECT AGAINST ARTICULAR EROSION IN RHEUMATOID-ARTHRITIS

Objective-To examine the hypothesis that gold rings might delay articu lar erosion at the metacarpophalangeal (MCP) joint of the left ring fi nger in ring wearers with rheumatoid arthritis (RA). Methods-Consecuti ve patients with RA were recruited. They were classified as ring weare rs if they had worn a gold ring on the left ring finger throughout mos t of the time since disease onset, or as non-ring wearers if they had never worn a gold ring. Standard hand radiographs (with rings removed, where possible) were taken and articular erosion was quantified at th e MCP and proximal interphalangeal joints. Results-Thirty ring wearers (27 female) and 25 non-ring wearers (12 female) were included. The me dian (25th-75th centile) Larsen score in the left hand ring MCP joint of ring wearers was 1.0 (1.0-2.0), which was significantly less than i n their equivalent right hand joint (1.0, 1.0-5.0, p = 0.01). It also tended to be less than the equivalent left hand joint of non-ring wear ers (4.0, 1.0-5.0, p = 0.06), with a similar but significant differenc e observed at the adjacent middle finger MCP joint (p = 0.01). Conclus ions-The results of this preliminary study suggest that there may be l ess articular erosion at the left hand ring, and perhaps adjacent, MCP joints observed in ring wearers with RA. These data support the hypot hesis that gold could pass from a gold ring through skin and local lym phatics 'downstream' to nearby MCP joint in sufficient quantities to d elay articular erosion.