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Abstract Number: 1962

The Value Of the  2010 ACR/EULAR Rheumatoid Arthritis Classification Criteria For The Prognosis Of Early Arthritis: Evaluation Of Erosion Development With Ultrasonography

Nevsun Inanc1, Fatma Alibaz-Oner2, Meryem Can3, Pamir Atagündüz2 and Haner Direskeneli2, 1Department of Rheumatology, Marmara University School of Medicine, Istanbul, Turkey, 2Rheumatology, Marmara University, School of Medicine, Istanbul, Turkey, 3Department of Rheumatology, Marmara University, School of Medicine, Istanbul, Turkey

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: classification criteria and ultrasonography, Early Rheumatoid Arthritis

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Session Information

Session Title: Imaging in Rheumatoid Arthritis

Session Type: Abstract Submissions (ACR)

Background/Purpose:

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. 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 one 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 ulnar styloid and 5th MTP joints were performed prospectively at the lateral approach longitudinally and transversally for  the determination of the erosion at baseline and 12months.

Results:

A total of 71 patients (F/M:53/18) were recruited to the study.  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 classified 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). 

Conclusion:

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 erosive patients which may predict the prognosis of RA.


Disclosure:

N. Inanc,
None;

F. Alibaz-Oner,
None;

M. Can,
None;

P. Atagündüz,
None;

H. Direskeneli,
None.

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