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Do gold rings protect against articular erosion in rheumatoid
arthritis?
a Department of Rheumatology, City Hospital NHS
Trust, Birmingham , b Department of Rheumatology, Coventry and Warwickshire
Hospital, Coventry
Correspondence to: Dr R D Situnayake, Department of Rheumatology, City Hospital NHS Trust, Dudley Road, Birmingham B18 7QH.
Accepted for publication 22 May 1997
OBJECTIVE
To examine the hypothesis that gold
rings might delay articular erosion at the metacarpophalangeal (MCP)
joint of the left ring finger in ring wearers with rheumatoid arthritis (RA).
METHODSConsecutive patients with RA were
recruited. They were classified as ring wearers if they had worn a gold
ring on the left ring finger throughout most 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 the MCP and proximal
interphalangeal joints.
RESULTSThirty ring wearers (27 female) and 25 non-ring wearers (12 female) were included. The median (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 in 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 wearers
(4.0, 1.0-5.0, p = 0.06), with a similar but significant difference
observed at the adjacent middle finger MCP joint (p = 0.01).
CONCLUSIONSThe results of this preliminary
study suggest that there may be less articular erosion at the left hand
ring, and perhaps adjacent, MCP joints observed in ring wearers with
RA. These data support the hypothesis that gold could pass from a gold
ring through skin and local lymphatics `downstream' to nearby MCP
joint in sufficient quantities to delay articular erosion.
© 1997 by Annals of the Rheumatic Diseases
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