RESEARCH - Incidence of elbow involvement in RA. A 15 year endpoint study.

September 2, 2005

Journal of Rheumatology

January 2001

Incidence of Elbow Involvement in Rheumatoid Arthritis. A 15 Year Endpoint

Study

JANNE T. LEHTINEN, KALEVI KAARELA, MIKKO IKÄVALKO, MARKKU J. KAUPPI, EERO A.

BELT, PEKKO P. KUUSELA, HANNU J. KAUTIAINEN, and MATTI U.K. LEHTO

ABSTRACT.

Objective. To evaluate the incidence of involvement and cause of destruction

of humeroulnar (HU) and humeroradial (HR) joints in a prospectively followed

cohort of 74 patients with seropositive and erosive rheumatoid arthritis

(RA).

Methods. At the 15 year followup standard anteroposterior and lateral

radiographs of 148 elbow joints were evaluated, and the grade of destruction

was assessed by the Larsen method.

Results. Erosive involvement (Larsen grade 2) was observed in 75/148 (51%)

elbows in 45/74 (61%) patients; 30 patients had bilateral and 15 unilateral

involvement. The incidence of mild erosions (Larsen grade 2) was 49/148

(33%), and severe erosions (Larsen 3-5) 26/148 (18%). The 13 most severely

involved (Larsen grade 4-5) joints were seen in 8 (11%) patients. Erosions

were most often observed on the capitellum (64 joints) and the lateral

epicondyle (58 joints) of the humerus (AP view) or on the olecranon of the

ulna (52 joints). The Larsen score (0-100) for peripheral joints correlated

significantly with the elbow joint Larsen grade on both sides: right, r =

0.53 (95% CI 0.34 to 0.68); left, r = 0.53 (95% CI 0.34 to 0.68).

Conclusion. After 15 years more than half of the elbows and almost 2 of 3

patients with RA showed definite involvement of the elbow joint. Erosions

were most often located on the capitellum and the lateral epicondyle of the

humerus or the olecranon of the ulna. Severe destruction was most often

bilateral. (J Rheumatol 2001;28:70-4)

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Mayo Clinic in Rochester

s Hopkins Medicine

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