Abstract

Objective To investigate the clinical factors related to radiological progression in rheumatoid arthritis （RA） and the role of radiology in the assessment of RA outcomes. Methods A total of 178 cases of active rheumatic arthritis were enrolled in a 2-year trial given radiological assessment at baseline and during follow up. These cases were classified into three groups, namely groups 1, 2 and 3 for mild, moderate and severe based on baseline X-ray images of joint damage. Radiological progression, clinical remission and Health Assessment Questionnaire （HAQ） were used in the two-year follow-up and analyzed for the correlation between each other. Results At the end point, groups 1 and 2 did not differ in radiologieal progression（P〉0.05）. Significant difference was found between group 1 （15.4%, 12/78）and group 2（30.0%, 9130） （P〈0.05） , as well as between group 3 （11.9% , 7159） and group 3 （P〈0.05） , suggesting that radiological damages may deteriorate more in patients with higher level of hone erosion at baseline. After 2 years of medications, the rate of clinical remission in all the cases was 85.0% （142/167） and was not different among the three groups （P〉0.05） , which indicated that clinical remission had no relevance with radiological progression. Conclusion Female gender, positive rheumatoid factor, high HAQ scores and peri- articular lesions are risk factors for radiological progression in RA. EarLy use of disease-modifying antirheumatie drugs （within less than 6 months） is benefieial fi~r patients with radiological progression. X-ray is sufficiently effective to confirm, re-evaluate and determine the articular erosion. Clinical remission may not necessarily indicate suspension of radiologieal progression and routine X-ray is required in the whole follow up process of RA in order to modify medications based on progression of artieular lesions. Key words: Arthritis, rheumatoid ; Radiography ; Rheumatoid factor; Disease - modifying antirheumatic drugs; Joint damage

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