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Very recent onset arthritis: the value of initial rheumatologist evaluation and anti-cyclic citrullinated peptide antibodies in the diagnosis of rheumatoid arthritis.

Abstract：

:The objective of this study is to identify baseline factors associated with rheumatoid arthritis (RA) diagnosis at the end of 1-year follow-up in a cohort of patients with very recent onset arthritis. Incident cases with self-reported arthritis (or=1 swollen joint the diagnosis of RA at the end of follow-up. Patients were regularly seen and diagnosed through follow-up by staff rheumatologists who were blind to diagnostic prediction. Of 119 referrals, 78 (65.5%; age 35.5 +/- 13.5 years; 69 females) were diagnosed at baseline as very recent onset arthritis (median duration 6 weeks (0-12 weeks)); of 75 patients completing 1-year follow-up, 51 (66.5%) were classified as RA; 12 (16%) had self-limited arthritis; and 13 (17.5%) other diagnoses. The characteristics of patients with RA as final diagnosis were polyarthritis, morning stiffness >or=1 h, high counts of swollen joints, and low frequency of systemic symptoms. Rheumatologist prediction of RA and anti-cyclic citrullinated peptide (anti-CCP) antibodies was strongly associated with RA as a final diagnosis in the logistic regression analysis. Sensitivity and specificity of the rheumatologist prediction were 94% and 74%, for anti-CCP antibodies, 56% and 96%; the combination of both variables had a specificity of 100% and a sensitivity of 53%, and a positive predictive value of 98%. The combination of RA as predicted diagnosis by a rheumatologist and anti-CCP antibodies is highly specific for RA diagnosis in patients with very early arthritis.

journal_name

Clin Rheumatol

journal_title

Clinical rheumatology

authors

Rojas-Serrano J,Burgos-Vargas R,Pérez LL,García CG,Moctezuma F,Vázquez-Mellado J

doi

10.1007/s10067-009-1206-z

subject

Has Abstract

pub_date

2009-10-01 00:00:00

pages

1135-9

issue

10

eissn

0770-3198

issn

1434-9949

journal_volume

28

pub_type

杂志文章

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