Stability of normal joint findings in persistent classic rheumatoid arthritis

We reviewed the records of 44 patients, retrospectively selected because they had had persistently active rheumatoid arthritis for more than 5 years (mean +/- SD followup 9.8 +/- 2.6 years) and because they met the American Rheumatism Association criteria for classic disease, to determine the change in extent of the anatomic distribution of joint involvement over time. The positive predictive value of a lack of inflammation in a joint during the first year for the lack of involvement over the ensuing 4 years was 87%. Thirty-eight of the 43 joints that required replacement were inflamed in the first year of disease.