Clinical Synovitis and Radiological Lesions in Rheumatoid Arthritis: A Prospective Study of 25 Patients during Treatment with Remission-inducing Drugs

Abstract

The joints of hands and feet of 25 patients (1150 joints) with rheumatoid arthritis were compared, joint by joint, clinically and radiologically, over 2 years of treatment with remission-inducing drugs. Joints with clinical signs of synovitis decreased from 47% to 17% (p<0.001), while the number of joints with radiological lesions increased from 23% to 27% (p<0.01). Definite radiological progression of bone lesions was seen in 7 % of the joints. Joints with clinical synovitis had a higher risk of progressive bone damage than joints without clinical synovitis (p<0.001) and joints in which the clinical signs of synovitis persisted during the study had a higher risk of progressing bone lesions than joints in which the clinical synovitis subsided (p<0.001). Progressive bone damage was seen more often in swollen joints than in tender joints without swelling or joints without clinical signs of synovitis (p<0.001), the difference in radiological progression between the latter two groups being non-significant. Twenty-one per cent of the joints with progressive bone lesions had no clinical signs of synovitis during the period.