Forefoot Joints Don't Improve 28-Joint Count Measurement

In early RA, inclusion of forefoot joint doesn't improve measurement range, precision

WEDNESDAY, July 25 (HealthDay News) -- For the assessment of patients with early rheumatoid arthritis (RA), including forefoot joints does not significantly improve the precision or range of measurement of the 28-tender and swollen joint count, according to a study published online July 16 in Arthritis Care & Research.

Liseth Siemons, of the University of Twente in Enschede, Netherlands, and associates analyzed baseline measures of tender and swollen joint counts in 459 early RA patients to evaluate the contribution of assessing forefoot joints to the range and precision of joint count measurement.

The researchers found that 50.76 percent of patients experienced tenderness and 43.57 percent had swelling in one or more forefoot joints. Forefoot joints were more informative for the measurement of joint tenderness than for joint swelling, but inclusion of forefoot joints did not significantly improve the precision or range measurements of 28-joint counts. The existing discrepancy between the joint and patient distributions in both joint counts was not removed by the inclusion of forefoot joints.

"Forefoot joints were frequently affected on an individual level, but did not significantly improve the measurement range or precision of 28-joint counts in early RA patients," the authors write. "From a measurement perspective, reduced joint counts are appropriate for use on a population level."

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