Moon Joo Cheong1, Chong Hyuk Chung2

1 Department of Medicine, Wonkwang University School of Medicine, Iksan, Korea 2 Division of Rheumatology, Department of Internal Medicine, Wonkwang University Hospital, Iksan, Korea


Background: The purpose of this study was to identify the distribution characteristics of radiological damage to the hand of rheumatoid arthritis patients and evaluate its effectiveness using a new damage assessment method.
Methods: Hand radiographs of a total of 127 rheumatoid arthritis patients were evaluated. We simplified the pre-existing van der Heijde modified total sharp score to assess the extent of bone damage. We selected 36 joints in both hands as regions of interest in our own way, and the erosion and joint space narrowing were scored.
Results: When the erosion and joint space narrowing score values of each joint of the hand were added togeth- er, the joint space narrowing score was higher than the overall erosion score. We can see that the scaphoid,lu- nate,radius and ulnar joints have higher erosion scores, and the 4th proximal interphalangeal (PIP), Scaphoid, Lunate, and Radius joints have higher joint space narrowing scores than other joints. These damage assess- ment results were similar to the results from the previous damage assessment model.
Conclusions: The joint space narrowing score is higher than the erosion score, suggesting that joint space nar- rowing precedes erosion. When checking the hand X-ray of rheumatoid arthritis patients, it is necessary to carefully check the scaphoid,lunate,radius and ulnar and 4th PIP joints, which relatively high radiographic dam- age scores. Also, the damage assessment model used in this study is relatively simple and does not show dif- ference in analysis results from existing assessment models, so it can be considered for application in follow-up research.
Korean J Health Promot 2023;23(4):209-216

Keywords: Rheumatoid arthritis, Hand X-ray, Radiographic damage