X-ray changes in connection with late synovectomy of the hand in rheumatoid arthritis

Eighty-two patients subjected to late synovectomy of the hand were followed up. Late synovectomy was defined as an operation performed after at least 3 years' duration of local synovitis in the type of joint operated on. The minimum follow-up period was 24 months for the fingers joints (IP + PIP and MCP) and 18 months for the dorsal aspect of the wrist (W). The multifocal swelling of joints, preoperatively, was symmetrical in 89% of the patients. The X-ray changes, however, were symmetrical in only 22%, 27%, and 68% for IP + PIP, MCP, and W, respectively. These findings may preclude the use of controlled studies on early synovectomy using the non-operated hand as a control in a long-term assessment of X-ray progression. The rate of X-ray progression during the observation period was 60% for IP + PIP joints. The corresponding figures for MCP and W were 64% and 39%, respectively. Absence of bony lesions prior to synovectomy was favourable sign.