The Comparison of Joint Erosion in Conventional Radiographs between Rheumatoid Arthritis Patients and Arthralgia Patients without Arthritis Findings
Abstract
Background: Rheumatoid arthritis (RA) is a systemic autoimmune disorder characterized by chronic inflammation leading to joint erosions and functional impairment. Early detection of joint damage is critical for effective treatment and improved patient outcomes. This study evaluates the diagnostic utility of conventional radiography in detecting joint erosions in RA patients compared to individuals with arthralgia without arthritis findings.
Methods: This retrospective cross-sectional study included 42 RA patients diagnosed based on the 2010 ACR/EULAR classification criteria and 44 age- and gender-matched individuals with arthralgia but no arthritis findings. Conventional radiographs of hand and foot joints were evaluated for erosions by a single rheumatologist in a blinded fashion. Intra-observer reliability was assessed using Cronbach’s alpha. Statistical analyses were conducted using t-tests, chisquare tests, and Mann-Whitney U tests.
Results: Hand radiographs showed significantly higher erosion counts in RA patients compared to the arthralgia group (p < 0.01). Erosion rates in foot joints were less prevalent and showed no significant difference between groups (p > 0.99). Intra-observer reliability for hand radiographs was excellent (Cronbach’s alpha: 0.897), underscoring the reliability of conventional radiography. However, foot radiographs exhibited reduced evaluability due to technical challenges.
Conclusion:Hand radiographs are a reliable and practical tool for early detection and monitoring of joint erosions in RA, particularly in hand joints. Foot radiographs, though less reliable, may require methodological enhancements for broader applicability. Conventional radiography remains a cost-effective diagnostic approach while advanced imaging modalities such as MRI and ultrasonography offer complementary benefits.
Keywords
Rheumatoid arthritis, conventional radiography, joint erosion, diagnostic imaging, arthralgia
Ethical Statement
As the corresponding author, I hereby declare that there is no conflict of interest related to this manuscript. The authors have no relevant financial or non-financial interests to disclose.
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