Conventional X-ray in early arthritis

This article reviews radiographic data from six cohorts of patients with early inflammatory arthritis. Radiographic scoring was not applied for diagnostic purposes but to detect damage as consequence synovitis with poor prognosis, in most studies rheumatoid arthritis. Class scoring methods were applied to detect and quantify damage. Of the patients, 8% to 15% had erosive disease at the first encounter with the rheumatologist, but baseline damage was low in early inflammatory arthritis. Yearly progression in damage score was assessed only in patients with high suspicion of rheumatoid arthritis at baseline or who had a final diagnosis of rheumatoid arthritis at follow-up and varied between 0.5% and 1.7% of the maximal damage of the scoring method per year. The large number of patients with zero values for erosions and lower progression rates will influence sample sizes in clinical trials in early inflammatory arthritis when including radiographic change as an outcome.