Background The 2010 ACR/EULAR Rheumatoid Arthritis(RA) classification criteria was developed to diagnose the early arthritis patients who will progress destructive disease and to start early treatment.
Objectives We aimed to investigate the value of these classification criteria for the prognosis of early arthritis patients with the evaluation of the longitudinal ultrasonographic(US) examination for the development of erosions.
Methods The study included patients presenting with at least on)e swollen joints to “Early arthritis Clinic” between 2009 and 2012. The patients having symptom duration less than 24 months were recruited to the study. Clinical evaluation(tender/swollen joint counts, DAS28 and HAQ scores) and US examination of erosion at 2nd MCP, 5th MCP, 2nd PIP and 5th MTP joints were performed prospectively at the lateral approach longitudinally and transversally for the determination of the erosion score at baseline and 12months.
Results A total of 71 patients (F/M:53/18) were included. The mean age was 38.2±14.2, mean symptom duration was 6.4 (0-24) months. At baseline assessment, 46.5% (n:33) of patients were classification as RA according to 2010 ACR/EULAR criteria and others were diagnosed as undiffererentiated arthritis(UA) after excluding other possible diagnosis. At baseline, higher percentage of patients whom was diagnosed as RA according to 2010 ACR/EULAR criteria (44% vs 23%, p= 0.072) were found to have erosive changes with the US examination. Furthermore, a tendency was observed for the progression of erosive disease, in terms of increased number of erosive joints, in patients diagnosed according to 2010 criteria vs patients diagnosed as UA (32% vs 10% p=0.072) at follow-up. Positive RF was also determined as a predictor of erosions by US (35% vs 11%, p=0.053).
Conclusions Among patients with early arthritis fulfilling the 2010 ACR/EULAR RA criteria had erosive disease at diagnosis and increased frequency of erosions during the follow-up. Early evaluation of the joints by US can be used for the early detection of erosions which may predict the prognosis of RA.
Disclosure of Interest None Declared