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Koevoets, R.; Machado, P.; Bombardier, C.; Heijde, D.M. van der (2011)

The Value of Conventional Radiographs in Undifferentiated Arthritis: A Systematic Review

Article / Letter to editor
Objective. To perform a systematic literature review on the diagnostic and predictive value of conventional radiographs (CR) in patients with undifferentiated arthritis (UA). Methods. We performed an extended search using Medline. Embase, the Cochrane Library, and abstracts from the 2007 and 2008 meetings of the American College of Rheumatology and the European League Against Rheumatism. Articles were included based on predefined inclusion criteria, and quality was assessed by using validated quality scales. Results. In total, 25 articles were included from 6003 retrieved references. Five articles described a pure UA population, 20 articles described a mixed population [mostly rheumatoid arthritis (RA) and UA]. In studies on UA, erosions on CR were strong predictors of RA diagnosis [positive likelihood ratio (LR+) 3.5-10.9; odds ratio 7.6 and 8.7). In a more heterogeneous mixed population, 20 studies reporting on 11 cohorts found a relationship between CR findings and subsequent...Show moreObjective. To perform a systematic literature review on the diagnostic and predictive value of conventional radiographs (CR) in patients with undifferentiated arthritis (UA). Methods. We performed an extended search using Medline. Embase, the Cochrane Library, and abstracts from the 2007 and 2008 meetings of the American College of Rheumatology and the European League Against Rheumatism. Articles were included based on predefined inclusion criteria, and quality was assessed by using validated quality scales. Results. In total, 25 articles were included from 6003 retrieved references. Five articles described a pure UA population, 20 articles described a mixed population [mostly rheumatoid arthritis (RA) and UA]. In studies on UA, erosions on CR were strong predictors of RA diagnosis [positive likelihood ratio (LR+) 3.5-10.9; odds ratio 7.6 and 8.7). In a more heterogeneous mixed population, 20 studies reporting on 11 cohorts found a relationship between CR findings and subsequent diagnosis of RA. LR+ for erosions and/or bony decalcifications ranged from 1.8 to 9.7, and there was greater prevalence of erosions and higher Sharp-van der Heijde score in the RA group at followup. With regard to prognosis in both UA and mixed populations, an association was found between number of abnormalities on CR and poor outcome. Conclusion. Several studies, in pure UA and mixed populations, clearly demonstrate that CR are helpful in predicting future diagnosis of RA or worse prognosis. However, absence of abnormalities on CR does not sufficiently exclude RA or other unfavorable outcome. (J Rheumatol 2010;38 Suppl 87:26-30; doi:10.3899/jrheum.101071)Show less
SYSTEMATIC REVIEW UNDIFFERENTIATED ARTHRITIS IMAGING RADIOGRAPHS PREDICTIVE VALUE DIAGNOSTIC VALUE cyclic citrullinated peptide early rheumatoid-arthritis unclassified polyarthritis disease-activity recent-onset antibodies cohort classification scintigraphy inception
All authors
Koevoets, R.; Machado, P.; Bombardier, C.; Heijde, D.M. van der
Date
2011-03-31
Journal
Journal of Rheumatology
Volume
38
Pages
26 - 30