Session Information
Date: Monday, November 9, 2015
Title: Imaging of Rheumatic Diseases Poster II: X-ray, MRI, PET and CT
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose:
Untreated rheumatoid arthritis (RA) often leads to joint space narrowing (JSN) and erosions in synovial joints. Scoring systems like Sharp van der Heijde and Larsen are commonly used as outcome measures in clinical trials, but they are time consuming and thus not used in clinical practice. It would be important to introduce a simple radiographic measure to guide treatment decisions in clinical routine. For Sharp van der Heijde score the simplified score “SENS” (1) is available. As we use Larsen score in our studies, we wished to know if a simplified Larsen score would be feasible. Thus, we applied the “simplified Larsen erosion score” (SLES), documenting the number of joints with erosions, and evaluated whether or not it corresponds to radiological changes assessed by the total Larsen score.
Methods:
217 patients diagnosed with recent onset RA in the Swedish “TIRA-2” cohort participated in this study. All patients fulfilled the ACR 1987 criteria. Radiography of hands and feet were performed at diagnosis, 1, 2 and 3 years. The radiographs were scored by the classical Larsen score and by SLES where 32 joints (PIP 2-5, MCP 2-5, four quadrants in the wrist, MTP 2-5) are assessed – in Larsen score both JSN and erosions, in SLES only erosions. In Larsen score changes are graded from 0-5 (0= no changes, 5= mutilating changes). The total Larsen score range is 0-160. In SLES, erosions are graded only as present or not, i.e. 0= no change and 1= erosion(s). The SLES range is 0-32.
Results: Of the 217 patients included with radiographs at inclusion 155 had radiographs at 1 year, 119 at 2 years and 168 at 3 years. Using Spearman’s Correlation test, SLES gave the same information as Larsen score regarding radiographic joint damage as well as the total Larsen score (p<0,01) at all time points. (Table 1)
Table 1
|
|
Total Larsen, mean |
SLES, mean |
Correlation coefficient |
P-value |
|
0 months |
2.58 |
0.31 |
0.496 |
<0.01 |
|
12 months |
2.83 |
0.40 |
0.433 |
<0.01 |
|
24 months |
3.42 |
0.47 |
0.483 |
<0.01 |
|
36 months |
4.27 |
0.51 |
0.494 |
<0.01 |
Conclusion:
Simplified Larsen erosion score provided similar information regarding radiographic changes as the total Larsen score among our patients with recent onset RA (<0.01). As being less time consuming, the SLES could be an applicable tool to rapid and easy assessment of radiographic damage.
Reference: 1. The usefulness of the Simplified Erosion Narrowing Score (SENS) in clinical practice for estimating joint damage in early rheumatoid arthritis. Forslind K; BARFOT Study Group. Scand J Rheumatol. 2011 Nov;40(6):497-8
To cite this abstract in AMA style:
Ziegelasch M, Kastbom A, Skogh T, Forslind K. Simplified Larsen Erosion Score Is Compatible with the Classic Larsen Score but Less Time Consuming in Practice [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/simplified-larsen-erosion-score-is-compatible-with-the-classic-larsen-score-but-less-time-consuming-in-practice/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/simplified-larsen-erosion-score-is-compatible-with-the-classic-larsen-score-but-less-time-consuming-in-practice/