Preview

Rheumatology Science and Practice

Advanced search

In the question about early diagnosis of rheumatoid arthritis

https://doi.org/10.14412/1995-4484-2003-760

Abstract

Objective. To define the most important manifestations of early RA. Methods. 92 pts aged 17 to 45 years (mean 34,9 ±8,52 years) with RA of 2-3 activity degree diagnosed during the first months of the disease (mean 3,5 months), were investigated and followed up for one year. Inclusion criteria was the absence of serious concomitant disease of internal organs. Results. During the follow up diagnosis of RA was confirmed in 90 patients (97,8%). SLE was diagnosed in 2 ptss. During the first months of the disease the most considerable manifestations were: morning stiffness, elevation of CRP (3+ and more) - 59 pts (65,5%) and ESR (more than 40 mm/h) - 21 ptss (23,3%), RF more than 1/160 - 46 pts (51,1%). Generalization of joint syndrome (more than 3 joints involved) had all pts at the sixth month of the disease. The onset of the disease with monoarthritis was revealed in 9 of pts (10%), oligoarthritis in 15 (16,7%), polyarthritis in 66 (73,3%). Conclusion. The most important manifestations of early RA are morning stiffness, RF (+), increase of CRP, symmetrical polyarthritis of hands and feet.

References

1. <div><p>Багринцева К.М., Федотова Н.М., Стародубова А.В. Ранний ревматоидный артрит. Клинико-иммунологическая характеристика. Мед. журнал молодых исслед., 1998, 11. 11-19.</p><p>Беневоленская Л.И. Бржезовский М.М. Эпидемиология ревматических болезней. М., "Медицина”, 1988, 2745.</p><p>Насонова В.А., Астапенко М.Г. Клиническая ревматология. М., "Медицина", 1989, 253-318.</p><p>Насонова В.А., Сигидин Я.А. Базисная терапия ревматоидного артрита в ранней стадии. Тер.архив, 1996, 5. 5-8.</p><p>Насонова В.А., Бунчук Н.В. Ревматические болезни. М. "Медицина". 1997, 257-304.</p><p>Насонов Е.Л. Инфекция вирусом иммунодефицита человека. ревматическая патология и аутоиммунитет. Тер.архив, 1990. 5, 141-147.</p><p>Раденека С.Г., Насонова В.А., Новикова А.В. Ранний ревматоидный синовит и его эволюция. Тер.архив, 1998, 4. 45-47.</p><p>Сальникова Т.С., Балабанова P.M., Сороцкая В.Н. Срав нительная оценка эффективности делагила, сульфаса лазина и метотрексата в начальной стадии ревматоидного артрита (6-месячное наблюдение). Актуальные вопросы в клинике внутренних болезней. М., "Медицина”. 2001, 297-305.</p><p>Сигидин Я.А., Гусева Н.Г., Иванова М.М. Диффузные болезни соединительной ткани. М. "Медицина", 1994, 91-227.</p><p>Тимофеев В.Т., Шостак Н.А., Логинова А.А и др. Иммунологические аспекты диагностики рандой стадии ревматоидного артрита. Тер.архив, 2000,5, 21-25.</p><p>Backhaus М., Kamradt Т., Sandrok D. et al. Arthritis of the finger jonts. A comprehensive approach comparing conventional radiography, scintigraphy, ultrasonound and con- trastenhanced magnetic resonans imaging. Arthr. Rheum.,1999,42,1232-1245.</p><p>Breedveld F.C. New insights in the pathogenesis of rheumatoid arthritis. J. Rheumatol., 1998,25,5,3 - 6.</p><p>Chan K.W., Felson D.T., lood R.A. et al. The lag time between onset of symptoms and diagnosis of rheumatoid arthritis. Arthr. Rheum., 1994,37,6, 814-820.</p><p>Conaghan P.G., Wakefield R., O' Connor P. et al. New appoaches to imaging of early rheumatoid arthritis. Clin. Exp. Rheumatol. 1999,17,537-542.</p><p>Cordonnier C., Meyer O., Palazzo E. et al. Diagnostic value of anti-RA 33 antibody, antikeratin antibody, antiperinu- clear factor and antinuclear antibody in early rheumatoid arthritis: comparison with rheumatoid factor. Br. J.Rheumatol., 1996,35,620 -624.</p><p>Dougados М., Combe B., Contagrel A. et al. Combination therapy in early rheumatoid arthritis: a randomised, controlled double blind 52-week clinical trial of sulfasalazine and inetotrexate compared with the single components. Ann. Rheum. Dis., 1999, 58, 4, 220 - 226.</p><p>Emery P. Therapeutic approaches for early rheumatoid arthritis. How early? How aggresive? Br. J. Rheumatol., 1995. 34, 2, 87 - 90.</p><p>Emery P., Symmons D.P. What early rheumatoid arthritis? - definition and diagnosis. Clin. Rheumatol. 1997, 11(1). 13 - 26.</p><p>Emery' P., Mazzo H., Proudman S. Management of patients with newly diagnosed rheumatoid arthritis. Rheumatol., 1999, 38, 27 -31.</p><p>Gordon D.A. Complicating factors in the diagnosis and management of rheumatoid arthritis. J. Rheumatol., 1999, 28,112, 12 - 14.</p><p>Houssien D.A., Scott D.L. Early referral and outcome in rheumatoid arthritis. Scand. J. Rheumatol., 1998, 27, 300 - 302.</p><p>Hulsemann J.L., Zeidler H. Diagnostic evalution of classification criteria for rheumatoid arthritis and reactive arthritis in an early synovitis outpatient clinic. Ann.Rheum.Dis., 1999. 58. 278 - 280.</p><p>Irvine S. Munro R. Poster D. Early referral, diagnosis and treatment of rheumatoid arthritis: evidence for changing medical practice. Ann. Rheum.Dis., 1999, 58, 8, 510 - 514.</p><p>Jansen L.M.A. Predictors of functional status in patients with early rheumatoid arthritis. Ann. Rheum. Dis., 2000. 69 3, 223 - 227.</p><p>Jorgensen C., Cyteval C., Anaya J.M. Sensitivity of magnetic resonance imaging in patients with early rheumatoid arthritis. Br. J. Rheumatol., 1997, 36, 636 -638.</p><p>Kaarela K. Prognostic factors and diagnostic criteria in early rheumatoid arthritis. J. Rheumatol., 1985, 57, 1 - 54.</p><p>Kim J.M. Weisman M.N. When does rheumatoid arthritis begin and why do we need to know? Arthr. Rheum., 2000, 43, 3. 473 - 484.</p><p>Mottonen Т., Paimela L., Leirisalo-Repo М., et al. Only high disease activity and positive rheumatoid factor indicate poor prognosis in patients with early rheumatoid arthritis treated with "sawtooth" strategy. Ann. Rheum. Dis., 1999. 58 (5), 323.</p><p>Speyer J., Hazes J.М. Breedveld F.C, et al. Recruitment of patients with early rheumatoid arthritis - the Nethelands experience. J. Rheumatol. Suppl., 1996, 44, 84 -85.</p><p>Teitsson J., Withrington R.A., Seifert M.H. et al. Prospective study of early rheumatoid arthritis. Prognostis value of Ig A rheumatoid factor. Ann. Rheum. Dis., 1984, 43, 5, 673 - 678.</p><p>Tunn E.J., Bacon P.A. Differentiating persistent from self- limiting symmetrical synovitis in an early arthritis clinic. Br. J. Rheumatol., 1993, 32 (2), 97-103.</p></div><br />


Review

For citations:


Salnikova T.S., Balabanova R.M. In the question about early diagnosis of rheumatoid arthritis. Rheumatology Science and Practice. 2003;41(2):7-10. (In Russ.) https://doi.org/10.14412/1995-4484-2003-760

Views: 1182


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1995-4484 (Print)
ISSN 1995-4492 (Online)