Should Joint Deformity, which is More Common Than Swelling or Tenderness, be Assessed in all Rheumatoid Arthritis Patients and Databases?

Objective We analyzed 28 joint counts in 173 contemporary routine care patients with rheumatoid arthritis (RA), who had disease duration of 10 years and were examined in 2021, for swollen joint count (SJC), tender joint count (TJC)/pain on motion, and deformity joint count (DJC)/limited motion. In a...

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Main Authors: Theodore Pincus, Tengfei Li, Kathryn A. Gibson
Format: Article
Language:English
Published: Wiley 2025-05-01
Series:ACR Open Rheumatology
Online Access:https://doi.org/10.1002/acr2.70025
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author Theodore Pincus
Tengfei Li
Kathryn A. Gibson
author_facet Theodore Pincus
Tengfei Li
Kathryn A. Gibson
author_sort Theodore Pincus
collection DOAJ
description Objective We analyzed 28 joint counts in 173 contemporary routine care patients with rheumatoid arthritis (RA), who had disease duration of 10 years and were examined in 2021, for swollen joint count (SJC), tender joint count (TJC)/pain on motion, and deformity joint count (DJC)/limited motion. In addition, we computed DJC according to Disease Activity Score in 28 joints (DA28), Clinical Disease Activity Index (CDAI), and Routine Assessment of Patient Index Data 3 (RAPID3) as remission/low or moderate/high activity or severity. Methods This report presents a retrospective analyses of a cross‐sectional Australian database for medians and prevalences of SJC, TJC, and DJC, including in RA index categories. Results Median values were 0 for SJC, 2.0 for TJC, and 4.0 for DJC, respectively, including SJC of 0,1 in 123 patients (71%), TJC of 0,1 in 82 patients (47%), SJC+TJC of 0,1 in 73 patients (42%), and DJC of 0,1 in 65 patients (38%). Among 4,498 joints, 1,330 with any abnormality included 286 swollen joints (6%), 590 tender joints (13%), 879 deformed joints (20%), 37 only swollen joints (1%), 289 only tender joints (6%), 659 only deformed joints (15%), 458 joints with two abnormalities (10%), and 80 joints with three abnormalities (2%). The 73 of all 173 with patients with SJC and TJC 0,1 (42%), included 56% to 67% who were classified in remission or low DAS28 ESR erythrocyte sedimentation rate, CDAI, or RAPID3 activity or severity, of whom 47% to 58% had DJC ≥2, whereas 11% to 36% were classified as moderate or high RA index activity or severity, of whom 57% to 58% had DJC ≥2. Conclusion SJC+TJC of 0,1 was more common than a DJC of 0,1 in contemporary patients with RA. DJC was ≥2 in the majority of patients who met SJC+TJC remission criteria for RA indices, as in patients who were classified as moderate/high although they met SJC+TJC remission criteria. DJC should be included in long‐term routine care and RA databases.
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spelling doaj-art-42b9e3ba41d14bb29bbd5dea57b482d02025-08-20T03:31:20ZengWileyACR Open Rheumatology2578-57452025-05-0175n/an/a10.1002/acr2.70025Should Joint Deformity, which is More Common Than Swelling or Tenderness, be Assessed in all Rheumatoid Arthritis Patients and Databases?Theodore Pincus0Tengfei Li1Kathryn A. Gibson2Rush University Medical Center Chicago IllinoisRush University Medical Center Chicago IllinoisLiverpool Hospital and Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia, and University of New South Wales, Medicine and Health Sydney New South Wales AustraliaObjective We analyzed 28 joint counts in 173 contemporary routine care patients with rheumatoid arthritis (RA), who had disease duration of 10 years and were examined in 2021, for swollen joint count (SJC), tender joint count (TJC)/pain on motion, and deformity joint count (DJC)/limited motion. In addition, we computed DJC according to Disease Activity Score in 28 joints (DA28), Clinical Disease Activity Index (CDAI), and Routine Assessment of Patient Index Data 3 (RAPID3) as remission/low or moderate/high activity or severity. Methods This report presents a retrospective analyses of a cross‐sectional Australian database for medians and prevalences of SJC, TJC, and DJC, including in RA index categories. Results Median values were 0 for SJC, 2.0 for TJC, and 4.0 for DJC, respectively, including SJC of 0,1 in 123 patients (71%), TJC of 0,1 in 82 patients (47%), SJC+TJC of 0,1 in 73 patients (42%), and DJC of 0,1 in 65 patients (38%). Among 4,498 joints, 1,330 with any abnormality included 286 swollen joints (6%), 590 tender joints (13%), 879 deformed joints (20%), 37 only swollen joints (1%), 289 only tender joints (6%), 659 only deformed joints (15%), 458 joints with two abnormalities (10%), and 80 joints with three abnormalities (2%). The 73 of all 173 with patients with SJC and TJC 0,1 (42%), included 56% to 67% who were classified in remission or low DAS28 ESR erythrocyte sedimentation rate, CDAI, or RAPID3 activity or severity, of whom 47% to 58% had DJC ≥2, whereas 11% to 36% were classified as moderate or high RA index activity or severity, of whom 57% to 58% had DJC ≥2. Conclusion SJC+TJC of 0,1 was more common than a DJC of 0,1 in contemporary patients with RA. DJC was ≥2 in the majority of patients who met SJC+TJC remission criteria for RA indices, as in patients who were classified as moderate/high although they met SJC+TJC remission criteria. DJC should be included in long‐term routine care and RA databases.https://doi.org/10.1002/acr2.70025
spellingShingle Theodore Pincus
Tengfei Li
Kathryn A. Gibson
Should Joint Deformity, which is More Common Than Swelling or Tenderness, be Assessed in all Rheumatoid Arthritis Patients and Databases?
ACR Open Rheumatology
title Should Joint Deformity, which is More Common Than Swelling or Tenderness, be Assessed in all Rheumatoid Arthritis Patients and Databases?
title_full Should Joint Deformity, which is More Common Than Swelling or Tenderness, be Assessed in all Rheumatoid Arthritis Patients and Databases?
title_fullStr Should Joint Deformity, which is More Common Than Swelling or Tenderness, be Assessed in all Rheumatoid Arthritis Patients and Databases?
title_full_unstemmed Should Joint Deformity, which is More Common Than Swelling or Tenderness, be Assessed in all Rheumatoid Arthritis Patients and Databases?
title_short Should Joint Deformity, which is More Common Than Swelling or Tenderness, be Assessed in all Rheumatoid Arthritis Patients and Databases?
title_sort should joint deformity which is more common than swelling or tenderness be assessed in all rheumatoid arthritis patients and databases
url https://doi.org/10.1002/acr2.70025
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