Can erosion severity be predictor of functional status in patients with rheumatoid arthritis?

Yıl 2018, Cilt: 6 Sayı: 1, 9 - 14, 07.05.2018

Gülnur Taşçı Bozbaş , Faruk Şendur

Öz

Aim:
Rheumatoid arthritis (RA) is a systemic disease that primarily characterized by
chronic inflammation of the diarthrodial joints. Synovitis, joint erosions and
functional disorders are the main findings of the disease. In this study, we
aimed to investigate whether functional impairment is related to radiological
erosions in RA

Methods:Sixty-eight
patients who diagnosed to have RA according toAmerican College of Rheumatology
(ACR) criteria were included in the study. The demographic characteristics of
patients, the duration and severity of morning stiffness imprisonment, and the
severity of pain were recorded. Erythrocyte sedimentation rate (ESR) and
C-reactive protein (CRP) were evaluated. Disease activity was assessed by Ritch
index and DAS28 score, and functional status by Health Assessment Questionnaire
(HAQ) and Duruöz Hand Index (DHI). The severity of the erosions was graded
according to the Larsen score from radiographs of hand and foot

Results:
Patients had the mean age 54.30±11.27 
and an average disease duration of 8,4±6,4 years.  There was no correlation between HAQ and DHI
and Larsen score (p> 0.05). However, statistically significant correlation
was found between HAQ and DHI with duration and severity of morning stiffness,
verbal pain score, Ritch index and DAS 28(p<0.05).

Conclusion:
The radiological erosisons in patients with RA may not be indicator of
functional status. Therefore, we think that not only radiological evaluation
but also functional status must be followed by regularly in  the planning and follow-up of RA.

Anahtar Kelimeler

Rheumatoid arthritis, severity of erosion, Larsen score, functional status, HAQ

Romatoid Artritli Hastalarda Erozyon Şiddeti Fonksiyonel Durumun Belirleyicisi Olabilir Mi?

Öz

Amaç:
Romatoid artrit (RA) başlıca diartrodial eklemlerin kronik inflamasyonu ile
karakterize sistemik bir hastalıktır. Sinovit, eklem erozyonları ve fonksiyonel
bozukluk hastalığın temel bulgularıdır. Bu çalışmada RA’da fonksiyonel
bozukluğun radyolojik erozyonlarla ilişkisi olup olmadığını araştırmayı
amaçladık.

Materyal-metod:
Amerika Romatoloji Birliği (ACR) kriterlerine göre RA tanısı konan 68 (59
kadın, 9 erkek) hasta çalışmaya alındı. Hastaların demografik özellikleri,
sabah tutukluğunun süresi ve şiddeti, ağrının şiddeti sorgulandı. Laboratuar
parametrelerinden eritrosit sedimantasyon hızı (ESR) ve C-reaktif protein (CRP)
düzeyleri değerlendirildi. Hastalık aktivitesi Ritch indeksi ve DAS28 skoru
ile, fonksiyonel durum ise Sağlık Değerlendirme Anketi (HAQ) ve Duruöz El
Skalası (DHI) ile değerlendirildi. Erozyonların şiddeti el ve ayak
grafilerinden Larsen skoruna göre derecelendirildi. 

Bulgular:
Çalışmaya alınan hastaların ortalama yaşı 54.30±11.27 ve ortalama hastalık süresi 8,4±6,4 yıldı. HAQ ve DHI
ile Larsen skoru arasında herhangi bir korelasyon saptanmadı (p>0.05).  Ancak gerek HAQ, gerekse DHI ile sabah
tutukluğunun süresi ve şiddeti, verbal ağrı skoru, ritch indeksi ve DAS 28
skorları arasında istatistiksel olarak anlamlı korelasyon saptandı (p<0.05).

Sonuç:
RA’lı hastalarda radyolojik olarak saptanan erozyonlar fonksiyonel durumun bir
göstergesi olmayabilir. Bu nedenle RA’da tedavinin planlanmasında ve takibinde
sadece radyolojik değerlendirmelerle sınırlı kalınmayarak hastaların
fonksiyonel durumlarının da mutlaka düzenli takip edilmesi gerektiğini
düşünmekteyiz

Anahtar Kelimeler

Romatoid artrit, erozyon şiddeti, Larsen skoru, Fonksiyonel durum, HAQ

Kaynakça

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