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Analysis of the affected joints in rheumatoid arthritis patients in a large Japanese cohort

Analysis of the affected joints in rheumatoid arthritis patients in a large Japanese cohort Abstract Objective: Rheumatoid arthritis (RA) is a chronic inflammatory disorder involving multiple joints. We investigated the distribution of the affected joints and the relationships among this distribution, the disease activity, and the disease duration in Japanese RA patients by cross-sectional analysis using the National Database of Rheumatic Diseases by iR-net in Japan. Materials and methods: A total of 6408 RA patients registered in the database were analyzed. In each patient, the location of joint swelling and joint tenderness of 68 joints was examined, and the relationships among the distribution of the affected joints, the disease activity as determined using the DAS28-ESR, and the disease duration were analyzed statistically. Results: For the 6408 RA patients examined, the wrist was the most frequently affected site. There were some differences in the prevalence of tenderness and swelling; tenderness was frequently observed in large joints such as the knee, elbow and shoulder, while swelling was frequently observed in small joints such as the metacarpophalangeal joints. Although the frequency of involvement increased in all joints as disease activity increased, the pattern of distribution was not affected by disease activity. Furthermore, the distribution was not influenced by disease duration. Conclusions: Based on the results of this study, we can draw the following conclusions: (1) the wrist was the most affected joint; (2) there was a discrepancy between the distribution of swollen joints and that of tender joints; and (3) the distribution of affected joints was uniform regardless of disease activity. Cohort, Distribution, Rheumatoid arthritis, Swelling, Tenderness References Scott DL , Coulton BL, Popert AJ . Long term progression of joint damage in rheumatoid arthritis. Ann Rheum Dis . 1986 ; 45 ( 5 ): 373 – 8 . Google Scholar OpenURL Placeholder Text WorldCat Scott DL , Smith C, Kingsley G. Joint damage and disability in rheumatoid arthritis : an updated systematic review. Clin Exp Rheumatol . 2003 ; 21 (5 Suppl 31 ): 520 – 7 . Goekoop-Ruiterman YP , de Vries-Bouwstra JK, Allaart CF, van Zeben D, Kerstens PJ, Hazes JM, et al. Clinical and radiographic outcomes of four different treatment strategies in patients with early rheumatoid arthritis ( the BeSt study ): a randomized, con-trolled trial. Arthritis Rheum . 2005 ; 52 ( 11 ): 3381 – 90 . Grigor C , Capell H, Stirling A, McMahon AD, Lock P, Vallance R, et al. Effect of a treatment strategy of tight control for rheu-matoid arthritis (the TICORA study): a single-blind randomised controlled trial . Lancet . 2004 ; 364 ( 9430 ): 263 – 9 . Google Scholar Crossref Search ADS PubMed WorldCat Nell VP , Machold KP, Eberl G, Stamm TA, Uffmann M, Smolen JS. Benefit of very early referral and very early therapy with disease-modifying anti-rheumatic drugs in patients with early rheumatoid arthritis . Rheumatology (Oxford) . 2004 ; 43 ( 7 ): 906 – 14 . Google Scholar Crossref Search ADS PubMed WorldCat Lard LR , Visser H, Speyer I, vander Horst-Bruinsma IE, Zwin-derman AH, Breedveld FC, et al . Early versus delayed treatment in patients with recent-onset rheumatoid arthritis: comparison of two cohorts who received different treatment strategies. Am J Med . 2001 ; 111 ( 6 ): 446 – 51 . Google Scholar OpenURL Placeholder Text WorldCat Drossaers-Bakker KW , de Buck M, van Zeben D, Zwinderman AH, Breedveld FC, Hazes JM. Long-term course and outcome of functional capacity in rheumatoid arthritis : the effect of disease activity and radiologic damage over time. Arthritis Rheum . 1999 ; 42 ( 9 ): 1854 – 60 . Nishino J , Tanaka S, Matsui T, Mori T, Nishimura K, Eto Y, et al. Prevalence of joint replacement surgery in rheumatoid arthritis patients: cross-sectional analysis in a large observational cohort in Japan . Mod Rheumatol . 2009 ; 19 ( 3 ): 260 – 4 . Google Scholar Crossref Search ADS PubMed WorldCat Yasui T , Nishino J, Kadono Y, Matsui T, Nakamura K, Tanaka S, et al. Impact of biologics on the prevalence of orthopedic surgery in the National Database of Rheumatic Diseases in Japan . Mod Rheumatol . 2010 ; 20 ( 3 ): 233 – 7 . Google Scholar Crossref Search ADS PubMed WorldCat Prevoo ML , van't Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL . Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum . 1995 ; 38 ( 1 ): 44 – 8 . Google Scholar OpenURL Placeholder Text WorldCat Cooper B , Ahlquist M, Friedman RM, Loughner B, Heft M . Properties of high-threshold mechanoreceptors in the oral mucosa. I. Responses to dynamic and static pressure. J Neuro-physiol . 1991 ; 66 ( 4 ): 1272 – 9 . Google Scholar OpenURL Placeholder Text WorldCat Davis KD , Meyer RA, Campbell JN . Chemosensitivity and sen-sitization of nociceptive afferents that innervate the hairy skin of monkey. J Neurophysiol . 1993 ; 69 ( 4 ): 1071 – 81 . Google Scholar OpenURL Placeholder Text WorldCat Randich A , Meller ST, Gebhart GF . Responses of primary afferents and spinal dorsal horn neurons to thermal and mechanical stimuli before and during zymosan-induced inflam-mation of the rat hindpaw. Brain Res . 1997 ; 772 ( 1-2 ): 135 – 48 . Google Scholar OpenURL Placeholder Text WorldCat Pogatzki EM , Gebhart GF, Brennan TJ . Characterization of A-delta- and C-fibers innervating the plantar rat hindpaw one day after an incision. J Neurophysiol . 2002 ; 87 ( 2 ): 721 – 31 . Google Scholar OpenURL Placeholder Text WorldCat Yamashita T , Minaki Y, Takebayashi T, Sakamoto N, Ishii S . Neural response of mechanoreceptors to acute inflammation in the rotator cuff of the shoulder joint in rabbits. Acta Orthop Scand . 1999 ; 70 ( 2 ): 137 – 40 . Google Scholar OpenURL Placeholder Text WorldCat Ochi T , Iwase R, Yonemasu K, Matsukawa M, Yoneda M, Yu-kioka M, et al . Natural course of joint destruction and fluctuation of serum Clq levels in patients with rheumatoid arthritis. Arthritis Rheum . 1988 ; 31 ( 1 ): 37 – 43 . Google Scholar OpenURL Placeholder Text WorldCat This content is only available as a PDF. © 2013 Japan College of Rheumatology This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) © 2013 Japan College of Rheumatology http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Modern Rheumatology Oxford University Press

Analysis of the affected joints in rheumatoid arthritis patients in a large Japanese cohort

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References (18)

Publisher
Oxford University Press
Copyright
Copyright © 2022 Japan College of Rheumatology
ISSN
1439-7595
eISSN
1439-7609
DOI
10.3109/s10165-012-0636-7
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Abstract

Abstract Objective: Rheumatoid arthritis (RA) is a chronic inflammatory disorder involving multiple joints. We investigated the distribution of the affected joints and the relationships among this distribution, the disease activity, and the disease duration in Japanese RA patients by cross-sectional analysis using the National Database of Rheumatic Diseases by iR-net in Japan. Materials and methods: A total of 6408 RA patients registered in the database were analyzed. In each patient, the location of joint swelling and joint tenderness of 68 joints was examined, and the relationships among the distribution of the affected joints, the disease activity as determined using the DAS28-ESR, and the disease duration were analyzed statistically. Results: For the 6408 RA patients examined, the wrist was the most frequently affected site. There were some differences in the prevalence of tenderness and swelling; tenderness was frequently observed in large joints such as the knee, elbow and shoulder, while swelling was frequently observed in small joints such as the metacarpophalangeal joints. Although the frequency of involvement increased in all joints as disease activity increased, the pattern of distribution was not affected by disease activity. Furthermore, the distribution was not influenced by disease duration. Conclusions: Based on the results of this study, we can draw the following conclusions: (1) the wrist was the most affected joint; (2) there was a discrepancy between the distribution of swollen joints and that of tender joints; and (3) the distribution of affected joints was uniform regardless of disease activity. Cohort, Distribution, Rheumatoid arthritis, Swelling, Tenderness References Scott DL , Coulton BL, Popert AJ . Long term progression of joint damage in rheumatoid arthritis. Ann Rheum Dis . 1986 ; 45 ( 5 ): 373 – 8 . Google Scholar OpenURL Placeholder Text WorldCat Scott DL , Smith C, Kingsley G. Joint damage and disability in rheumatoid arthritis : an updated systematic review. Clin Exp Rheumatol . 2003 ; 21 (5 Suppl 31 ): 520 – 7 . Goekoop-Ruiterman YP , de Vries-Bouwstra JK, Allaart CF, van Zeben D, Kerstens PJ, Hazes JM, et al. Clinical and radiographic outcomes of four different treatment strategies in patients with early rheumatoid arthritis ( the BeSt study ): a randomized, con-trolled trial. Arthritis Rheum . 2005 ; 52 ( 11 ): 3381 – 90 . Grigor C , Capell H, Stirling A, McMahon AD, Lock P, Vallance R, et al. Effect of a treatment strategy of tight control for rheu-matoid arthritis (the TICORA study): a single-blind randomised controlled trial . Lancet . 2004 ; 364 ( 9430 ): 263 – 9 . Google Scholar Crossref Search ADS PubMed WorldCat Nell VP , Machold KP, Eberl G, Stamm TA, Uffmann M, Smolen JS. Benefit of very early referral and very early therapy with disease-modifying anti-rheumatic drugs in patients with early rheumatoid arthritis . Rheumatology (Oxford) . 2004 ; 43 ( 7 ): 906 – 14 . Google Scholar Crossref Search ADS PubMed WorldCat Lard LR , Visser H, Speyer I, vander Horst-Bruinsma IE, Zwin-derman AH, Breedveld FC, et al . Early versus delayed treatment in patients with recent-onset rheumatoid arthritis: comparison of two cohorts who received different treatment strategies. Am J Med . 2001 ; 111 ( 6 ): 446 – 51 . Google Scholar OpenURL Placeholder Text WorldCat Drossaers-Bakker KW , de Buck M, van Zeben D, Zwinderman AH, Breedveld FC, Hazes JM. Long-term course and outcome of functional capacity in rheumatoid arthritis : the effect of disease activity and radiologic damage over time. Arthritis Rheum . 1999 ; 42 ( 9 ): 1854 – 60 . Nishino J , Tanaka S, Matsui T, Mori T, Nishimura K, Eto Y, et al. Prevalence of joint replacement surgery in rheumatoid arthritis patients: cross-sectional analysis in a large observational cohort in Japan . Mod Rheumatol . 2009 ; 19 ( 3 ): 260 – 4 . Google Scholar Crossref Search ADS PubMed WorldCat Yasui T , Nishino J, Kadono Y, Matsui T, Nakamura K, Tanaka S, et al. Impact of biologics on the prevalence of orthopedic surgery in the National Database of Rheumatic Diseases in Japan . Mod Rheumatol . 2010 ; 20 ( 3 ): 233 – 7 . Google Scholar Crossref Search ADS PubMed WorldCat Prevoo ML , van't Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL . Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum . 1995 ; 38 ( 1 ): 44 – 8 . Google Scholar OpenURL Placeholder Text WorldCat Cooper B , Ahlquist M, Friedman RM, Loughner B, Heft M . Properties of high-threshold mechanoreceptors in the oral mucosa. I. Responses to dynamic and static pressure. J Neuro-physiol . 1991 ; 66 ( 4 ): 1272 – 9 . Google Scholar OpenURL Placeholder Text WorldCat Davis KD , Meyer RA, Campbell JN . Chemosensitivity and sen-sitization of nociceptive afferents that innervate the hairy skin of monkey. J Neurophysiol . 1993 ; 69 ( 4 ): 1071 – 81 . Google Scholar OpenURL Placeholder Text WorldCat Randich A , Meller ST, Gebhart GF . Responses of primary afferents and spinal dorsal horn neurons to thermal and mechanical stimuli before and during zymosan-induced inflam-mation of the rat hindpaw. Brain Res . 1997 ; 772 ( 1-2 ): 135 – 48 . Google Scholar OpenURL Placeholder Text WorldCat Pogatzki EM , Gebhart GF, Brennan TJ . Characterization of A-delta- and C-fibers innervating the plantar rat hindpaw one day after an incision. J Neurophysiol . 2002 ; 87 ( 2 ): 721 – 31 . Google Scholar OpenURL Placeholder Text WorldCat Yamashita T , Minaki Y, Takebayashi T, Sakamoto N, Ishii S . Neural response of mechanoreceptors to acute inflammation in the rotator cuff of the shoulder joint in rabbits. Acta Orthop Scand . 1999 ; 70 ( 2 ): 137 – 40 . Google Scholar OpenURL Placeholder Text WorldCat Ochi T , Iwase R, Yonemasu K, Matsukawa M, Yoneda M, Yu-kioka M, et al . Natural course of joint destruction and fluctuation of serum Clq levels in patients with rheumatoid arthritis. Arthritis Rheum . 1988 ; 31 ( 1 ): 37 – 43 . Google Scholar OpenURL Placeholder Text WorldCat This content is only available as a PDF. © 2013 Japan College of Rheumatology This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) © 2013 Japan College of Rheumatology

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Modern Rheumatology – Oxford University Press

Published: Jan 1, 2013

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