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Seronegative and seropositive rheumatoid arthritis: radiographic differences
G Y el-Khoury1, R K Larson, M H Kathol
1Department of Radiology, University of Iowa Hospital and Clinic, Iowa City 52242.
Radiology
|August 1, 1988
Summary
Radiological differences exist between seronegative and seropositive rheumatoid arthritis (RA) patients. Seropositive RA shows more erosions, while seronegative RA presents with osteosclerosis and fusion.
Area of Science:
- Rheumatology
- Radiology
- Immunology
Background:
- Rheumatoid arthritis (RA) is categorized into seronegative and seropositive subtypes.
- These subtypes exhibit distinct clinical, genetic, and immunologic profiles.
Purpose of the Study:
- To investigate radiological differences between seronegative and seropositive rheumatoid arthritis patients.
- To identify specific radiographic features that may distinguish between the two RA patient groups.
Main Methods:
- A cohort of 17 seronegative RA patients was closely matched with seropositive RA controls.
- Radiographs of hands and wrists were assessed blindly for specific features.
- Disease severity was quantified using a modified Beaver Creek grading sheet, evaluating osteosclerosis, new bone formation, carpal predominance, fusion, symmetry, and erosions.
Main Results:
- Seropositive RA patients demonstrated more severe disease with larger and more numerous erosions.
- Seronegative RA patients exhibited greater osteosclerosis, carpal predominance, fusion, and new bone formation.
- Symmetry of disease manifestation was comparable between the seronegative and seropositive groups.
Conclusions:
- Significant quantitative and qualitative radiological differences exist between seronegative and seropositive RA.
- Radiologists should exercise caution when differentiating RA subtypes based solely on radiographic findings due to considerable overlap.