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Joint assessment in rheumatoid arthritis
1Academic Rheumatology Unit, King's College School of Medicine and Dentistry, London.
British Journal of Rheumatology
|September 1, 1996
Summary
Assessing joint swelling and tenderness is crucial for rheumatoid arthritis (RA) management. While 28-joint and 66/68-joint counts are valid, the 28-joint method offers simplicity despite excluding foot joints.
Area of Science:
- Rheumatology
- Clinical Assessment
- Inflammation Measurement
Background:
- Joint counts are fundamental in rheumatoid arthritis (RA) clinical evaluation.
- Recent research has refined methods for measuring joint inflammation and identifying key joints for assessment.
Purpose of the Study:
- To review current approaches to joint counting in RA assessment.
- To compare the widely used 28-joint and 66/68-joint count methods.
Main Methods:
- Evaluation of existing research on joint inflammation measurement in RA.
- Comparison of the 28-joint count (excluding feet) and 66/68-joint count methods.
- Assessment of reproducibility, validity, and clinical utility of different joint counting strategies.
Main Results:
- Two primary joint counting methods exist: 66/68 joints or 28 joints, with the latter excluding foot joints.
- Both methods are reproducible and valid, providing similar clinical information.
- The 28-joint count is simpler and faster but may omit foot-related data; grading individual joint severity and weighted counts have limited acceptance.
Conclusions:
- Standardized training and international consensus on joint assessment methods are increasingly recognized as important.
- Joint counts remain a vital part of the core clinical data set for rheumatoid arthritis and are expected to continue to be essential in clinical practice.