Open AccessMeasuring disease activity: comparison of joint tenderness, swelling, and ultrasonography in rheumatoid arthritis
Author(s) -
Spiegel Timothy M.,
Iii William King,
Weiner Steven R.,
Paulus Harold E.
Publication year - 1987
Publication title -
arthritis & rheumatism
Language(s) - English
Resource type - Journals
eISSN - 1529-0131
pISSN - 0004-3591
DOI - 10.1002/art.1780301111
Subject(s) - medicine , rheumatoid arthritis , tenderness , swelling , joint effusion , concordance , ultrasonography , effusion , ultrasound , arthritis , arthrocentesis , osteoarthritis , surgery , radiology , pathology , synovial fluid , magnetic resonance imaging , alternative medicine
In a prospective study of 6 patients with classic rheumatoid arthritis, we evaluated 3 measures of disease activity: comprehensive joint swelling and joint tenderness counts, and ultrasonography of joints. After baseline data were obtained on these 6 patients, therapy with fenbufen, a new nonsteroidal antiinflammatory drug, was begun. Followup examinations were performed at 4 weeks and 24 weeks after baseline. There were statistically significant differences between joint tenderness and joint swelling findings and between joint tenderness and joint ultrasonography findings ( P < 0.05 by kappa test statistic). In comparisons of joint swelling and ultrasonography, no difference was found ( P > 0.05). When measures of changes over 6 months were compared, there was a high concordance between improvement in joint swelling and improvement in joint ultrasonography ( P < 0.01). Our results demonstrate that clinical assessment of joint swelling provides an accurate measure of synovial effusion, as confirmed by the more objective ultrasound measurements.