Frequency of abnormal hand and wrist radiographs at time of diagnosis of polyarticular juvenile rheumatoid arthritis

Thomas Mason, Ann M. Reed, Audrey M. Nelson, Kristen B. Thomas, Alice Patton, Alan D. Hoffman, Sara Achenbach, William M. O'Fallon

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Objective. To determine the frequency of radiographic abnormalities in hand/wrist radiographs of children with newly diagnosed polyarticular juvenile rheumatoid arthritis (polyJRA) because radiographs of small joints are an important tool in assessing outcomes in RA and there are clinical similarities between RA and polyJRA. Methods. A medical record review was performed to identify cases of polyJRA seen at Mayo Clinic from January 1, 1994, to December 31, 2001. Hand/wrist radiographs, obtained at the time of diagnosis, were reviewed by 3 radiologists with attention to periarticular osteopenia, joint space narrowing (JSN), or erosion. At least 2 radiologists had to independently identify abnormal findings on the same radiograph. The relative carpal length (RCL), judged by Poznanski's method, was also determined. Results. From the review of 159 medical records, 60 cases of newly diagnosed polyJRA were identified. Twenty-five of these had hand/wrist radiographs at diagnosis; 18 sets were available for this study. Of those, 2/3 were female, 6% (1/18) had subcutaneous nodules, 7% (1/14) had elevated levels of serum rheumatoid factor, and 44% (7/16) had elevated serum levels of antinuclear antibodies. Median age at diagnosis was 10.2 years, median duration of hand/wrist symptoms at diagnosis was 10 months, and median number of joints with either swelling, pain on range of motion (ROM), or limited ROM was 14.5. Sixty-one percent of radiographs taken at the time of diagnosis of polyJRA were abnormal. While 44% had periarticular osteopenia, 28% had either erosions or JSN. Six (33%) had RCL > 2 SD below the mean for age. Five (83%) of those with RCL, > 2 SD below the mean for age, had periarticular osteopenia, JSN, or erosion. Conclusion. We conclude the frequency of abnormal hand/wrist radiographs is very high very early in the course of polyJRA. More studies are needed to determine to what extent these radiographic abnormalities correlate with clinical outcomes.

Original languageEnglish (US)
Pages (from-to)2214-2218
Number of pages5
JournalJournal of Rheumatology
Volume29
Issue number10
StatePublished - Oct 1 2002

Fingerprint

Juvenile Arthritis
Wrist
Hand
Joints
Metabolic Bone Diseases
Articular Range of Motion
Medical Records
Rheumatoid Factor
Antinuclear Antibodies
Serum
Pain

Keywords

  • Arthritis
  • Juvenile
  • Radiographs

ASJC Scopus subject areas

  • Rheumatology
  • Immunology

Cite this

Mason, T., Reed, A. M., Nelson, A. M., Thomas, K. B., Patton, A., Hoffman, A. D., ... O'Fallon, W. M. (2002). Frequency of abnormal hand and wrist radiographs at time of diagnosis of polyarticular juvenile rheumatoid arthritis. Journal of Rheumatology, 29(10), 2214-2218.

Frequency of abnormal hand and wrist radiographs at time of diagnosis of polyarticular juvenile rheumatoid arthritis. / Mason, Thomas; Reed, Ann M.; Nelson, Audrey M.; Thomas, Kristen B.; Patton, Alice; Hoffman, Alan D.; Achenbach, Sara; O'Fallon, William M.

In: Journal of Rheumatology, Vol. 29, No. 10, 01.10.2002, p. 2214-2218.

Research output: Contribution to journalArticle

Mason, T, Reed, AM, Nelson, AM, Thomas, KB, Patton, A, Hoffman, AD, Achenbach, S & O'Fallon, WM 2002, 'Frequency of abnormal hand and wrist radiographs at time of diagnosis of polyarticular juvenile rheumatoid arthritis', Journal of Rheumatology, vol. 29, no. 10, pp. 2214-2218.
Mason, Thomas ; Reed, Ann M. ; Nelson, Audrey M. ; Thomas, Kristen B. ; Patton, Alice ; Hoffman, Alan D. ; Achenbach, Sara ; O'Fallon, William M. / Frequency of abnormal hand and wrist radiographs at time of diagnosis of polyarticular juvenile rheumatoid arthritis. In: Journal of Rheumatology. 2002 ; Vol. 29, No. 10. pp. 2214-2218.
@article{0e976d59602d483caa13c1fa6b175bfc,
title = "Frequency of abnormal hand and wrist radiographs at time of diagnosis of polyarticular juvenile rheumatoid arthritis",
abstract = "Objective. To determine the frequency of radiographic abnormalities in hand/wrist radiographs of children with newly diagnosed polyarticular juvenile rheumatoid arthritis (polyJRA) because radiographs of small joints are an important tool in assessing outcomes in RA and there are clinical similarities between RA and polyJRA. Methods. A medical record review was performed to identify cases of polyJRA seen at Mayo Clinic from January 1, 1994, to December 31, 2001. Hand/wrist radiographs, obtained at the time of diagnosis, were reviewed by 3 radiologists with attention to periarticular osteopenia, joint space narrowing (JSN), or erosion. At least 2 radiologists had to independently identify abnormal findings on the same radiograph. The relative carpal length (RCL), judged by Poznanski's method, was also determined. Results. From the review of 159 medical records, 60 cases of newly diagnosed polyJRA were identified. Twenty-five of these had hand/wrist radiographs at diagnosis; 18 sets were available for this study. Of those, 2/3 were female, 6{\%} (1/18) had subcutaneous nodules, 7{\%} (1/14) had elevated levels of serum rheumatoid factor, and 44{\%} (7/16) had elevated serum levels of antinuclear antibodies. Median age at diagnosis was 10.2 years, median duration of hand/wrist symptoms at diagnosis was 10 months, and median number of joints with either swelling, pain on range of motion (ROM), or limited ROM was 14.5. Sixty-one percent of radiographs taken at the time of diagnosis of polyJRA were abnormal. While 44{\%} had periarticular osteopenia, 28{\%} had either erosions or JSN. Six (33{\%}) had RCL > 2 SD below the mean for age. Five (83{\%}) of those with RCL, > 2 SD below the mean for age, had periarticular osteopenia, JSN, or erosion. Conclusion. We conclude the frequency of abnormal hand/wrist radiographs is very high very early in the course of polyJRA. More studies are needed to determine to what extent these radiographic abnormalities correlate with clinical outcomes.",
keywords = "Arthritis, Juvenile, Radiographs",
author = "Thomas Mason and Reed, {Ann M.} and Nelson, {Audrey M.} and Thomas, {Kristen B.} and Alice Patton and Hoffman, {Alan D.} and Sara Achenbach and O'Fallon, {William M.}",
year = "2002",
month = "10",
day = "1",
language = "English (US)",
volume = "29",
pages = "2214--2218",
journal = "Journal of Rheumatology",
issn = "0315-162X",
publisher = "Journal of Rheumatology",
number = "10",

}

TY - JOUR

T1 - Frequency of abnormal hand and wrist radiographs at time of diagnosis of polyarticular juvenile rheumatoid arthritis

AU - Mason, Thomas

AU - Reed, Ann M.

AU - Nelson, Audrey M.

AU - Thomas, Kristen B.

AU - Patton, Alice

AU - Hoffman, Alan D.

AU - Achenbach, Sara

AU - O'Fallon, William M.

PY - 2002/10/1

Y1 - 2002/10/1

N2 - Objective. To determine the frequency of radiographic abnormalities in hand/wrist radiographs of children with newly diagnosed polyarticular juvenile rheumatoid arthritis (polyJRA) because radiographs of small joints are an important tool in assessing outcomes in RA and there are clinical similarities between RA and polyJRA. Methods. A medical record review was performed to identify cases of polyJRA seen at Mayo Clinic from January 1, 1994, to December 31, 2001. Hand/wrist radiographs, obtained at the time of diagnosis, were reviewed by 3 radiologists with attention to periarticular osteopenia, joint space narrowing (JSN), or erosion. At least 2 radiologists had to independently identify abnormal findings on the same radiograph. The relative carpal length (RCL), judged by Poznanski's method, was also determined. Results. From the review of 159 medical records, 60 cases of newly diagnosed polyJRA were identified. Twenty-five of these had hand/wrist radiographs at diagnosis; 18 sets were available for this study. Of those, 2/3 were female, 6% (1/18) had subcutaneous nodules, 7% (1/14) had elevated levels of serum rheumatoid factor, and 44% (7/16) had elevated serum levels of antinuclear antibodies. Median age at diagnosis was 10.2 years, median duration of hand/wrist symptoms at diagnosis was 10 months, and median number of joints with either swelling, pain on range of motion (ROM), or limited ROM was 14.5. Sixty-one percent of radiographs taken at the time of diagnosis of polyJRA were abnormal. While 44% had periarticular osteopenia, 28% had either erosions or JSN. Six (33%) had RCL > 2 SD below the mean for age. Five (83%) of those with RCL, > 2 SD below the mean for age, had periarticular osteopenia, JSN, or erosion. Conclusion. We conclude the frequency of abnormal hand/wrist radiographs is very high very early in the course of polyJRA. More studies are needed to determine to what extent these radiographic abnormalities correlate with clinical outcomes.

AB - Objective. To determine the frequency of radiographic abnormalities in hand/wrist radiographs of children with newly diagnosed polyarticular juvenile rheumatoid arthritis (polyJRA) because radiographs of small joints are an important tool in assessing outcomes in RA and there are clinical similarities between RA and polyJRA. Methods. A medical record review was performed to identify cases of polyJRA seen at Mayo Clinic from January 1, 1994, to December 31, 2001. Hand/wrist radiographs, obtained at the time of diagnosis, were reviewed by 3 radiologists with attention to periarticular osteopenia, joint space narrowing (JSN), or erosion. At least 2 radiologists had to independently identify abnormal findings on the same radiograph. The relative carpal length (RCL), judged by Poznanski's method, was also determined. Results. From the review of 159 medical records, 60 cases of newly diagnosed polyJRA were identified. Twenty-five of these had hand/wrist radiographs at diagnosis; 18 sets were available for this study. Of those, 2/3 were female, 6% (1/18) had subcutaneous nodules, 7% (1/14) had elevated levels of serum rheumatoid factor, and 44% (7/16) had elevated serum levels of antinuclear antibodies. Median age at diagnosis was 10.2 years, median duration of hand/wrist symptoms at diagnosis was 10 months, and median number of joints with either swelling, pain on range of motion (ROM), or limited ROM was 14.5. Sixty-one percent of radiographs taken at the time of diagnosis of polyJRA were abnormal. While 44% had periarticular osteopenia, 28% had either erosions or JSN. Six (33%) had RCL > 2 SD below the mean for age. Five (83%) of those with RCL, > 2 SD below the mean for age, had periarticular osteopenia, JSN, or erosion. Conclusion. We conclude the frequency of abnormal hand/wrist radiographs is very high very early in the course of polyJRA. More studies are needed to determine to what extent these radiographic abnormalities correlate with clinical outcomes.

KW - Arthritis

KW - Juvenile

KW - Radiographs

UR - http://www.scopus.com/inward/record.url?scp=0036789785&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036789785&partnerID=8YFLogxK

M3 - Article

C2 - 12375336

AN - SCOPUS:0036789785

VL - 29

SP - 2214

EP - 2218

JO - Journal of Rheumatology

JF - Journal of Rheumatology

SN - 0315-162X

IS - 10

ER -