Construct Validity of Radiographs of the Feet to Assess Joint Damage in Patients with Gout

2016 ◽  
Vol 44 (1) ◽  
pp. 91-94 ◽  
Author(s):  
Bart Spaetgens ◽  
Caroline van Durme ◽  
Casper Webers ◽  
An Tran-Duy ◽  
Thea Schoonbrood ◽  
...  
Keyword(s):  
Construct Validity ◽  
Joint Space Narrowing ◽  
Disease Duration ◽  
Negative Binomial ◽  
Joint Damage ◽  
Joint Space ◽  
Factors Associated ◽  
Erosion Score ◽  
Method Factors ◽  
Linear Regressions

Objective.To investigate construct validity of radiographic damage of the feet in gout.Methods.Radiographs of the feet were scored using the Sharp/van der Heijde method. Factors associated with damage were investigated by a negative binomial model, and contribution of damage to health by linear regressions.Results.Age, disease duration, serum uric acid, and tophi were associated with being erosive and erosion score. Tophi were associated with joint space narrowing. Erosions were associated (β 0.47, 95% CI 0.09–0.84) with physical function, but damage was not associated with overall physical health.Conclusion.Our results support construct validity for radiographs of the feet when assessing joint damage in gout.

Repair of Radiographic Joint Damage Following Treatment with Etanercept in Psoriatic Arthritis Is Demonstrable by 3 Radiographic Methods

2011 ◽  
Vol 38 (6) ◽  
pp. 1066-1070 ◽  
Author(s):  
LIHI EDER ◽  
VINOD CHANDRAN ◽  
DAFNA D. GLADMAN
Keyword(s):  
Psoriatic Arthritis ◽  
Scoring System ◽  
Joint Space Narrowing ◽  
Joint Damage ◽  
Joint Space ◽  
Radiographic Assessment ◽  
Radiographic Damage ◽  
Erosion Score ◽  
Sharp Score ◽  
Hands And Feet

Objective.Psoriatic arthritis (PsA) is characterized by varied radiographic features. We describe a patient with PsA with severe radiographic damage that improved significantly following treatment with etanercept. The improvement was documented by several methods of radiographic assessment.Methods.Etanercept was introduced in September 2005. Radiographs of the hands and feet were read using 3 methods: the modified Steinbrocker method, the van der Heijde (vdH) modification of the Sharp method, and the Ratingen scoring system.Results.In July 2009, radiographs of the hands and feet showed improvement in erosion score and joint space narrowing, while bony proliferation remained the same [43 by modified Steinbrocker, 26 by the vdH Sharp score (12 for erosions and 14 for joint space narrowing), and 56 by the Ratingen (18 for erosion and 38 for proliferation].Conclusion.The 3 radiographic methods were useful in demonstrating improvement in joint scores. The modified Steinbrocker method, which is the simplest, was able to reveal improvement in our patient.

scholarly journals POS0967 DESCRIPTION OF SACROILIAC CT FINDINGS IN PATIENTS WITH ANKYLOSING SPONDYLITIS AGED OVER 50 YEARS: PRELIMINARY RESULTS OF THE CASIAGE STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 748.2-749
Author(s):  
O. Fakih ◽  
M. Chouk ◽  
C. Prati ◽  
D. Wendling ◽  
F. Verhoeven
Keyword(s):  
Ankylosing Spondylitis ◽  
Joint Space Narrowing ◽  
Joint Space ◽  
Pelvic Bone ◽  
Factors Associated ◽  
Ct Findings ◽  
Total Score Range ◽  
Computed Tomography Scanning ◽  
Duration Of Disease ◽  
Si Joint

Background:Diagnosis of axial spondyloarthritis (SpA) is nowadays commonly made with the help of pelvic radiography or MRI. However, there is an important inter-observer variability for radiographs, and MRI is subject to possible false positives, and is not the best modality for studying structural lesions. Conversely, pelvic CT has an excellent specificity and appears to be more effective than radiography for the diagnosis of SpA [1]. However, CT findings in patients over 50 years of age have not been studied.Objectives:To describe sacroiliac (SI) joint CT characteristics in patients with ankylosing spondylitis (AS), aged 50 years or older.Methods:An observational, cross sectional study was performed using medical records from Besançon University Hospital’s rheumatology department, which were screened to identify patients with AS. A search was then carried out for patients over 50 years old in the hospital’s imaging archiving system to identify those who had benefited from a CT which included the SI joints in their entirety. Non-inclusion criteria were the existence of pelvic bone lesions and a history of pelvic radiotherapy. For each patient, CT was interpreted using a score previously used by Diekhoff et al. [2], dividing each SI joint into 12 regions, for each of which joint space narrowing (JSN), erosions, and sclerosis are assessed. For this study, we also observed the existence of intra-articular gas and diffuse idiopathic skeletal hyperostosis (DISH) lesions for each region. Quantitative variables are expressed as mean ± standard deviation, qualitative variables as numbers and percentages. Wilcoxon rank-sum test was used to determine factors associated with a higher CT score.Results:A total of 66 patients were included. Mean (SD) age was 65.10 ± 10.59 with a mean (SD) duration of disease of 22.87 ± 14.95 years. 60.29% were male, and 87.04 % were HLA-B27 positive. 40.30% had a bamboo spine. CT findings are described in Table 1. The vast majority of patients have a positive JSN score but significant erosions are found in only a minority of cases. This is partly explained by the fact that 55.9% of the patients had at least one complete bilateral ankylosis (and therefore no erosions) on one of the three slices studied. Bilateral anklylosis was associated with a longer duration of disease (p<0.001) and presence of bamboo spine (p<0.001). Also noteworthy is the low proportion of DISH compared to the general population in this age group, which is 15-25%.Factors associated with a higher total CT score were male sex (p=0.017), longer duration of disease (p<0.001), tobacco use (p=0.033), presence of bamboo spine (p=0.004), absence of DISH (p=0.045) and absence of intra-articular gas (p<0.001). The distribution of lesions appeared to be homogenous over all 24 regions studied (Figure 1).Conclusion:CT findings in AS patients over 50 years of age are mostly represented by changes in joint space, with bilateral ankylosis present in half of the patients. AS appears to be a protective factor for DISH.References:[1]Devauchelle-Pensec V, D’Agostino MA, Marion J, et al. Computed tomography scanning facilitates the diagnosis of sacroiliitis in patients with suspected spondylarthritis: Results of a prospective multicenter French cohort study. Arthritis Rheum 2012;64:1412–9. doi:10.1002/art.33466[2]Diekhoff T, Hermann K-GA, Greese J, et al. Comparison of MRI with radiography for detecting structural lesions of the sacroiliac joint using CT as standard of reference: results from the SIMACT study. Ann Rheum Dis 2017;76:1502–8. doi:10.1136/annrheumdis-2016-210640Table 1.Sacro-iliac CT findings using a score modified from Diekhoff et al.Mean total score (range 0-108)70.36±38.90Presence of joint space narrowing58 (85.29 %)Presence of erosion20 (29.41 %)Presence of sclerosis15 (22.06 %)Presence of Intra-articular gas22 (32.35 %)Presence of DISH3 (4.41 %)Figure 1.Mean scores per region in the anterior, central and posterior SI slices (JSN: joint space narrowing (0-4), Ero: erosions (0-3), Scl: sclerosis (0-2)).Disclosure of Interests:None declared.

SAT0031 CORRELATION BETWEEN IRREVERSIBLE PHYSICAL DISABILITY AND JOINT DAMAGE IN RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 945-946
Author(s):  
E. Cipolletta ◽  
A. Incorvaia ◽  
R. Mashadi Mirza ◽  
A. DI Matteo ◽  
M. Tardella ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Remission ◽  
Physical Disability ◽  
Scoring System ◽  
Disease Duration ◽  
Cartilage Damage ◽  
Joint Damage ◽  
Erosion Score ◽  
Hands And Feet ◽  
And Cartilage

Background:In rheumatoid arthritis (RA), irreversible physical disability appears to be more clearly associated with cartilage damage rather than with bone erosions (BE) using conventional radiography (CR) imaging.Objectives:To investigate the correlation between the ultrasound (US) and CR findings indicative of joint damage and irreversible physical disability in patients with RA in sustained clinical remission.Methods:Patients in sustained clinical remission according to the Simplified Disease Activity Index (SDAI)≤3.3 for at least 6 months were enrolled. The following data were regireted: age, disease duration, anti-cyclic citrullinated peptide (ACPA) antibody and rheumatoid factor (RF) status, Health Assessment Questionnaire (HAQ), CR of hands and feet [evaluated using the Simple Erosion Narrowing Score (SENS) method]. A standardized US examination was carried out to investigate the presence of BE (lateral side of II metacarpophalangeal, V metacarpophalangeal and V metatarsophalangeal joints and ulnar styloid) and of cartilage damage (II to V metacarpal heads), bilaterally. BE and cartilage damage were assessed according to OMERACT definitions. A semiquantitative scoring system for both BE (1) and cartilage damage (2) was adopted.Results:Ninety patients were consecutively enrolled. Average time for US evaluation was 10±2 minutes. Both SENS-JSN and US score of cartilage damage (US-CD) were significantly associated with irreversible disability (R=0.39, p<0.01 and R=0.46, p<0.01). US and CR showed a moderate agreement in the evaluation of cartilage damage (kappa=0.52, 95% confidence interval: 0.44-0.61).Figure 1.shows the association between disability and structural damage (A: US-CD, B: US-BE, C: SENS-JSN and D: SENS-BE). After adjusting for confounding factors (age, disease duration, ACPA and RF status, SENS-BE and US-BE) cartilage damage was the only significant predictor of irreversible disability both using CR (R2=0.31, adjusted R2=0.26, standardized β=0.36, p<0.01) and US (R2=0.31, adjusted R2=0.26, standardized β=0.34, p<0.01).Conclusion:This study supports the hypothesis that cartilage damage is more relevant than BE in determining irreversible disability in RA. Our data provide further evidence in favor of the external validity of US in the assessment of cartilage damage.References:[1] Ohrndorf S, Messerschmidt J, Reiche BE, et al. Evaluation of a new erosion score by musculoskeletal ultrasound in patients with rheumatoid arthritis: is US ready for a new erosion score? Clin Rheumatol. 2014;33:1255-62.[2] Mandl P, Studenic P, Filippucci E, et al. Development of semiquantitative ultrasound scoring system to assess cartilage in rheumatoid arthritis. Rheumatology (Oxford). 2019;58:1802-11.Disclosure of Interests:Edoardo Cipolletta: None declared, Antonella Incorvaia: None declared, Riccardo Mashadi Mirza: None declared, Andrea Di Matteo Grant/research support from: the publication was conducted while Dr. Di Matteo was an ARTICULUM fellow, Marika Tardella: None declared, Walter Grassi Speakers bureau: Prof. Grassi reports personal fees from AbbVie, personal fees from Celgene, personal fees from Grünenthal, personal fees from Pfizer, personal fees from Union Chimique Belge Pharma, outside the submitted work., Emilio Filippucci Speakers bureau: Dr. Filippucci reports personal fees from AbbVie, personal fees from Bristol-Myers Squibb, personal fees from Celgene, personal fees from Roche, personal fees from Union Chimique Belge Pharma, personal fees from Pfizer, outside the submitted work.

Serum Cartilage Oligometric Matrix Protein and Pettersson Scoring System As an Index for Hemophilic Arthropathy

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 2855-2855
Author(s):  
Hoda MA Hassab ◽  
Wessam M EL-Gendy ◽  
Khaled I M El-Noueam ◽  
Hayam M Abdel Ghany ◽  
Myssoon M Elwan
Keyword(s):  
Serum Level ◽  
Cartilage Oligomeric Matrix Protein ◽  
Matrix Protein ◽  
Joint Space Narrowing ◽  
Joint Damage ◽  
Joint Space ◽  
Functional Independence ◽  
Control Group ◽  
Hemophilic Arthropathy ◽  
Group I

Abstract The pathogenesis of hemophilic arthropathy is multifactorial, with changes occurring in the synovium, bone, cartilage, and blood vessels. Recurrent joint bleeding causes synovial proliferation and inflammation (hemophilic synovitis) that contributes to end stage degeneration (hemophilic arthropathy); with pain and limitation of motion that severely affects patients’ quality of life. The aim of the present study was to evaluate the degree of joint damage in boys with hemophilia using plain x-ray, and to measure serum level of human cartilage oligomeric matrix protein, to determine its relation to the degree of joint damage. The study was carried out on thirty boys with hemophilic arthropathy (group I) and ten healthy boys were included as control (group II). All hemophilic patients were scored for Functional independence score (FISH score) in hemophilia and radiological changes (Pettersson’s score) using conventional frontal and lateral radiographs of the most affected joint. Factor activity level was measured for all hemophilic patients while serum cartilage oligomeric matrix protein (COMP) was measured for hemophilic patients and control group. Among the thirty hemophilic patients, 26 (86.7%) patients were hemophilia A and 4 (13.3%) patients were hemophilia B All patients were receiving on demand replacement therapy using plasma derived Factor concentrate or fresh frozen plasma (FFP) according to availability. Fifteen patients (50%) had severe hemophilia, 7 (23.3%) had moderate and 8(26.72%) had mild hemophilia. A higher serum level of COMP with a mean of 757± 211.30 in the severe hemophiliacs, and a mean of 403.57 ± 86.49 and 211.25 ± 74.26 in the moderate and mild hemophiliacs respectively the difference was statistically significant (p < 0.001). Serum level of COMP in group I was significantly higher than in group II (p=0.004) with significant negative correlation with FISH score (r=-0.435 p=0.016). COMP correlated positively with joint space narrowing of the Pettersson score (r=0.421 p<0.001) and with total Pettersson score (r=0.421 p=0.020). The number of joints affected (during life) of hemophilic patients ranged between 1-12 with a mean of 5.50 ± 2.46 Joints. A significant positive correlation between serum level of COMP and number of joints affected (r = 0.487, p = 0.006). Joint space narrowing is the most important indicator of cartilage loss. Serum COMP level is indicative of the amount of joint damage in patients with hemophilic arthropathy. The combined scoring of functional independence and Pettersson in addition with serum levels of COMP give a good overview of the degree of hemophilic arthropathy Disclosures No relevant conflicts of interest to declare.

scholarly journals Usefulness of Ultrasound Imaging in Detecting Psoriatic Arthritis of Fingers and Toes in Patients with Psoriasis

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Clara De simone ◽  
Giacomo Caldarola ◽  
Magda D'Agostino ◽  
Angelo Carbone ◽  
Cristina Guerriero ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Joint Space Narrowing ◽  
Joint Damage ◽  
Joint Space ◽  
New Bone Formation ◽  
Chronic Plaque Psoriasis ◽  
X Ray ◽  
Dermatology Clinic ◽  
Soft Tissue Swelling ◽  
Psa Progression

Background. Given that clinical evaluation may underestimate the joint damage and that early treatment can slow down psoriatic arthritis (PsA) progression, screening psoriasis patients with imaging tools that can depict early PsA changes would entail clear benefits.Objective. To compare the ability of X-ray and ultrasound (US) examination in detecting morphological abnormalities consistent with early PsA in patients with psoriasis, using rheumatological evaluation as the gold standard for diagnosis.Methods. Patients with chronic plaque psoriasis and no previous PsA diagnosis attending our outpatient dermatology clinic and reporting finger/toe joint and/or tendon pain underwent X-ray and US evaluation; they were subsequently referred to a rheumatologist for clinical examination and review of imaging findings.Results. Abnormal US and/or X-ray findings involving at least one finger and/or toe (joints and/or tendons) were seen in 36/52 patients: 11 had one or more X-ray abnormalities, including erosion, joint space narrowing, new bone formation, periarticular soft tissue swelling, and periarticular osteoporosis; 36 had suspicious changes on US.Conclusion. US proved valuable in detecting joint and/or tendon abnormalities in the fingers and toes of patients with suspicious changes. The dermatologist should consider US to obtain an accurate assessment of suspicious findings.

scholarly journals Validity and Responsiveness of Combined Inflammation and Combined Joint Damage Scores Based on the OMERACT Rheumatoid Arthritis MRI Scoring System (RAMRIS)

2019 ◽  
Vol 46 (9) ◽  
pp. 1222-1227 ◽  
Author(s):  
Ulf Sundin ◽  
Mikkel Østergaard ◽  
Daniel Glinatsi ◽  
Anna-Birgitte Aga ◽  
Kim Hørslev-Petersen ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Scoring System ◽  
Bone Marrow Edema ◽  
Joint Space Narrowing ◽  
Joint Damage ◽  
Patient Characteristics ◽  
Joint Space ◽  
Damage Score ◽  
Derivation Cohort ◽  
Magnetic Resonance Imaging Mri

Objective.The RAMRIS [Outcome Measures in Rheumatology rheumatoid arthritis (RA) magnetic resonance imaging (MRI) Scoring system] is used in clinical RA trials. We have investigated methods to combine the RAMRIS features into valid and responsive scores for inflammation and joint damage.Methods.We used data from 3 large randomized early RA trials to assess 5 methods to develop a combined score for inflammation based on RAMRIS bone marrow edema, synovitis, and tenosynovitis scores, and a combined joint damage score based on erosions and joint space narrowing. Methods included unweighted summation, normalized summation, and 3 different variants of weighted summation of the RAMRIS features. We used a derivation cohort to calculate summation weights to maximize the responsiveness of the combined score. Construct validity of the combined scores was examined by assessing correlations to imaging, clinical, and biochemical measures. Responsiveness was tested by calculating the standardized response mean (SRM) and the relative efficiency of each score in a validation cohort.Results.Patient characteristics, as well as baseline and followup RAMRIS scores, were comparable between cohorts. All combined scores were significantly correlated to other imaging, clinical, and biochemical measures. Inflammation scores combined by normalized and weighted summation had significantly higher responsiveness in comparison to unweighted summation, with SRM (95% CI) for unweighted summation 0.62 (0.51–0.73), normalized summation 0.73 (0.63–0.83), and weighted summation 0.74 (0.64–0.84). For the damage score, there was a trend toward higher responsiveness for weighted summation.Conclusion.Combined MRI scores calculated by normalized or weighted summation of individual MRI pathologies were valid and responsive.

scholarly journals Continued inhibition of structural damage over 2 years in patients with rheumatoid arthritis treated with rituximab in combination with methotrexate

2010 ◽  
Vol 69 (6) ◽  
pp. 1158-1161 ◽  
Author(s):  
Stanley B Cohen ◽  
Edward Keystone ◽  
Mark C Genovese ◽  
Paul Emery ◽  
Charles Peterfy ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Structural Damage ◽  
Joint Space Narrowing ◽  
Joint Damage ◽  
Joint Space ◽  
Tnf Inhibitors ◽  
Inadequate Response ◽  
Intention To Treat ◽  
Damage Progression ◽  
Sustained Effects

BackgroundRituximab inhibited structural damage at 1 year in patients with rheumatoid arthritis (RA) who had had a previous inadequate response to tumour necrosis factor (TNF) inhibitors.ObjectiveTo assess structural damage progression through 2 years.MethodsIntention-to-treat patients with one post-baseline radiograph (rituximab n=281; placebo n=187) received background methotrexate (MTX) and were randomised to rituximab (2×1000 mg infusions, 2 weeks apart) or placebo; patients were eligible for rituximab re-treatment every 6 months. By week 104, 82% of the placebo population had received ≥1 dose of rituximab. Radiographic end points included the change in total Sharp score (TSS), erosion and joint space narrowing scores at week 104.ResultsAt week 104, significantly lower changes in TSS (1.14 vs 2.81; p<0.0001), erosion score (0.72 vs 1.80; p<0.0001) and joint space narrowing scores (0.42 vs 1.00; p<0.0009) were observed with rituximab plus MTX vs placebo plus MTX. Within the rituximab group, 87% who had no progression of joint damage at 1 year remained non-progressive at 2 years.ConclusionsRituximab plus MTX demonstrated significant and sustained effects on joint damage progression in patients with RA and a previously inadequate response to TNF inhibitors.

Clinical synovitis in a particular joint is associated with progression of erosions and joint space narrowing in that same joint, but not in patients initially treated with infliximab

2010 ◽  
Vol 69 (12) ◽  
pp. 2107-2113 ◽  
Author(s):  
N B Klarenbeek ◽  
M Güler-Yüksel ◽  
D M F M van der Heijde ◽  
H M J Hulsmans ◽  
P J S M Kerstens ◽  
...  
Keyword(s):  
Joint Space Narrowing ◽  
Clinical Signs ◽  
Joint Damage ◽  
Treatment Strategies ◽  
Joint Space ◽  
X Rays ◽  
Joint Level ◽  
Damage Progression ◽  
The Individual ◽  
Hands And Feet

ObjectivesTo assess the relationship between joint tenderness, swelling and joint damage progression in individual joints and to evaluate the influence of treatment on these relationships.MethodsFirst-year data of the Behandel Strategieën (BeSt) study were used, in which patients recently diagnosed as having rheumatoid arthritis (RA) were randomly assigned into four different treatment strategies. Baseline and 1-year x-rays of the hands and feet were assessed using the Sharp–van der Heijde score (SHS). With generalised estimating equations, 3-monthly assessments of tender and swollen joints of year 1 were related to erosion progression, joint space narrowing (JSN) progression and total SHS progression at the individual joint level (definition >0.5 SHS units) in year 1, corrected for potential confounders and within-patient correlation for multiple joints per patient.ResultsDuring year 1, 59% of all 13 959 joints analysed were ever tender and 45% ever swollen, 2.1% showed erosion progression, 1.9% JSN progression and 3.6% SHS progression. Swelling and tenderness were both independently associated with erosion and JSN progression with comparable OR, although with higher OR in the hands than in the feet. Local swelling and tenderness were not associated with local damage progression in patients initially treated with infliximab.ConclusionClinical signs of synovitis are associated with erosion and JSN progression in individual joints after 1 year in RA. A disconnect between synovitis and joint damage progression was observed at joint level in patients who were treated with methotrexate and infliximab as initial treatment, confirming the disconnect between synovitis and the development of joint damage in tumour necrosis factor blockers seen at patient level.

scholarly journals AB0134 RELATIONSHIP BETWEEN INFLAMMATORY RATIOS AND RADIOGRAPHIC JOINT DAMAGE IN RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1095.2-1095
Author(s):  
F. Maatoug ◽  
M. Slouma ◽  
R. Dhahri ◽  
O. Beskri ◽  
I. Gharsallah ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Structural Damage ◽  
Joint Space Narrowing ◽  
Joint Damage ◽  
Joint Space ◽  
Albumin Ratio ◽  
Sharp Score ◽  
The Mean ◽  
Modified Sharp Score ◽  
Joint Erosion

Background:The tight control strategy is recommended in rheumatoid arthritis to tailor treatment for patients. This strategy requires regular monitoring of both disease activity and structural damage. However, radiographic assessement cannot be performed frequently and the modified Sharp score is rarely evaluated in current practice. Besides, no biomarker was able to mirror structural damage (1).Objectives:Our study aimed to assess the relationship between the modified Sharp score and the inflammatory ratios (platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), fibrinogen to albumin ratio (FAR) and CRP to albumin ratio (CAR)).Methods:We performed a cross-sectional study including 53 patients with rheumatoid arthritis (RA). A cell blood count, fibrinogen and an albumin blood test were measured for each patient. Inflammatory ratios were also measured (PLR, NLR, LMR, FAR, and CAR). Modified Sharp score and its components (erosion score and joint space narrowing score) were evaluated using the radiograph of hand and foot.Patients with infectious or hematological diseases were excluded from the study.Statistical analysis was performed using SPSS (Statistical Package for Social Sciences).Results:Of the 53 patients, 39 were female (Sex Ratio: 2.8). The mean age was 53.9 ± 12.7 years. The mean disease duration was 10.1 ± 8.2 years.The average age of the onset of the disease was 43.8±13.5 years.The mean DAS 28-ESR score was 4.64 ± 1.23. Forty three patients had a score higher than 3.2 (patients with moderate or high disease activity).The mean values of PLR, NLR, LMR, FAR and CAR were 161.62 ± 86.59, 2.84 ± 2.39, 4.99 ± 3.23, 0.12 ± 0.06 and 1.15 ± 1.38.The mean scores of joint erosion and joint space narrowing were respectively 12.76 ± 15.05 and 33.57 ± 25.80. The mean modified Sharp score was 46.33 ± 37.74.There was a positive correlation between modified Sharp score and following ratios: PLR (r: 0.501; p <10-3), NLR (r: 0.302; p:0.031), FAR (r: 0.300; p:0.030), CAR (r:0.286; p:0.042).Moreover, a positive correlation between joint space narrowing score and these ratios was identified: PLR (r: 0.558; p <10-3), NLR (r: 0.428; p:0.002), FAR (r: 0.371; p:0.007), CAR (r:0.387; p:0.005).Joint erosion score correlated with PLR (r: 0.299; p:0.033).No correlation was found between LMR and radiographic score.Conclusion:Our study showed that the modified Sharp score correlated with PLR, NLR, FAR and CAR in patients with RA. This finding suggests that these ratios could be used as inexpensive and reliable markers to reflect radiographic joint damage.Longitudinal studies are necessary to confirm our results.References:[1]Syversen SW, Landewe R, Van Der Heijde D, Bathon JM, Boers M, Bykerk VP, et al. Testing of the OMERACT 8 draft validation criteria for a soluble biomarker reflecting structural damage in rheumatoid arthritis: a systematic literature search on 5 candidate biomarkers. J Rheumatol. 2009;36(8):1769-84.Disclosure of Interests:None declared

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