			Home About us Contact

Radiographic Scores (radiographic + score)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Inflammation and angiogenesis in osteoarthritis

ARTHRITIS & RHEUMATISM, Issue 8 2003
L. Haywood
Objective To quantify the relationship between inflammation and angiogenesis in synovial tissue from patients with osteoarthritis (OA). Methods Hematoxylin and eosin staining and histologic grading for inflammation were performed for 104 patients who met the American College of Rheumatology criteria for OA and had undergone total joint replacement or arthroscopy. A purposive sample of synovial specimens obtained from 70 patients was used for further analysis. Vascular endothelium, endothelial cell (EC) proliferating nuclei, macrophages, and vascular endothelial growth factor (VEGF) were detected by immunohistochemical analysis. Angiogenesis (EC proliferation, EC fractional area), macrophage fractional area, and VEGF immunoreactivity were measured using computer-assisted image analysis. Double immunofluorescence histochemical analysis was used to determine the cellular localization of VEGF. Radiographic scores for joint space narrowing and osteophyte formation in the knee were also assessed. Results Synovial tissue samples from 32 (31%) of 104 patients with OA showed severe inflammation; thickened intimal lining and associated lymphoid aggregates were often observed. The EC fractional area, EC proliferation, and VEGF immunoreactivity all increased with increasing histologic inflammation grade and increasing macrophage fractional area. In the synovial intimal lining, VEGF immunoreactivity was localized to macrophages and increased with increasing EC fractional area and angiogenesis. No inflammation or angiogenic indices were significantly correlated with radiographic scores. Conclusion Inflammation and angiogenesis in the synovium are associated with OA. The angiogenic growth factor VEGF generated by the inflamed synovium may promote angiogenesis, thereby contributing to inflammation in OA. [source]

Abnormal radiographic findings in 865 French Standardbred trotters and their relationship to racing performance

EQUINE VETERINARY JOURNAL, Issue S36 2006
A. COUROUCÉ-MALBLANC
Summary Reason for performing study: Developmental orthopaedic lesions are commonly found in French Standardbred horses. One of the main questions asked by trainers, owners and veterinarians is what impact these lesions have on the racing career and racing performances of horses. Objectives: To study the prevalence and distribution of developmental orthopaedic lesions in young French Standardbred trotters and to relate them to racing performance. Methods: Feet, fetlock, tarsus and stifle regions were radiographed in 865 two-year-old French Standardbred trotters. Abnormal radiographic findings (ARF) were evaluated for 12 anatomical sites identified in these areas, and a severity index given. Performance criteria were: success in qualification for racing, maximal and mean index of trot (ITR), an annual index calculated on the basis of the logarithm of earnings per starts, total earnings at 5 years, placed races compared to starts and longevity of the racing career. Analysis of variance were calculated to study the relationships between racing performance and the number of ARF or the severity index. Results: A total of 363 horses (42.0%) showed ARF. Prevalence of ARF was 18.3% in the plantar aspect of the hind fetlock and 10.6% in the proximal tarsus. Among the total population, 833 horses were considered for performance evaluation, 478 of them were qualified for racing. The number of ARF significantly affected racing longevity. However, the number of ARF did not affect performance categories according to maximal ITR. Concerning distribution of ARF, the number of plantar lesions in the fetlock significantly affected mean ITR. The index of severity did not provide more information for prognosis than the number of ARF. Conclusion: Longevity is the only criteria affected by ARF. When evaluating different sites, only the plantar fetlock region showed a significant relationship with mean ITR. Potential relevance: Number of ARF and radiographic score (RS) affect mean ITR and longevity but do not affect maximal ITR. A horse with a good racing ability will be a good performer but might have a racing career shortened because of orthopaedic problems in relation to developmental orthopaedic lesions. [source]

Correlation between routine radiographic findings and early racing career in French Trotters

EQUINE VETERINARY JOURNAL, Issue S36 2006
C. ROBERT
Summary Reasons for performing study: The relationship between the presence of radiological abnormalities and subsequent racing performance is controversial. However, as training is expensive and time consuming, it would save time and money to identify subjects with osteo-articular lesions not compatible with a normal racing career on the basis of routine radiographic screenings at yearling age. Objectives: To evaluate the impact of osteo-articular lesions on racing ability in French Trotters and identify radiographic changes associated with failure in ,qualification', in order to provide objective criteria for selection of horses based on their osteo-articular status. Hypothesis: The influence of radiographic findings (RF) on racing ability depends on their nature, location, clinical relevance and number. Methods: The limbs of 202 French Trotters were radiographed just before they started training. All the RF were graded according to a standardised protocol depending on their severity. The success in ,qualification' (first race in career of French Trotters) was the criteria used to assess racing ability. Breeders and trainers were questioned about the causes for horses not racing. Results: Overall 113 (55.9%) horses qualified. Osteoarticular lesions were directly responsible for nonqualification in 31% of the horses. Subjects with more than one abnormal RF, with abnormal RF on the fore-, hind-fetlock or proximal tarsus were less likely to qualify. Dorsal modelling in the front fetlock and osteochondrosis of the lateral trochlear ridge of the femur also significantly reduced the qualification rate. Conclusions: Most RF are compatible with beginning a racing career, but severe RF or multiple abnormal RF significantly compromise future racing career. Potential relevance: This study supports the use of routine radiographic programmes for detection of osteoarticular lesions in yearlings. A synthetic radiographic score, based on both the severity and the number of lesions, could be useful for breeders and trainers as complementary information to select their horses. [source]

Anaesthetic choice for palatal canine exposure

ORAL SURGERY, Issue 1-2 2010
S. Hetherington
Abstract Aim:, To determine if predicted difficulty of exposure of palatally displaced, unerupted canines assessed by radiographic score had influenced the choice between a local or a general anaesthetic procedure in adolescents. Materials and methods:, This was a retrospective analysis of patients undergoing surgical exposure of palatal canines between December 2005 and June 2008 in a dental hospital setting. A total of 56 subjects, for whom complete records were available, aged 16 years or under and assessed and treated by one surgeon, were included. The predicted degree of difficulty of exposure was graded from preoperative radiographs based on three criteria; the horizontal and vertical position of the crown, and the canine angulation (possible score range 3,11: higher score = more difficulty). The radiographic scores and patient age for the local anaesthetic and general anaesthetic groups were compared using Student's unpaired t -tests. Other variables including gender, other surgical treatment required and unilateral or bilateral exposure were evaluated by chi-squared analysis. Results:, Thirty-one (55%) patients were treated with local anaesthetic and 25 (45%) with general anaesthetic, the mean age was 13.7 years. The mean radiographic scores did not differ between groups being 7.53 and 7.36 for the local anaesthetic and general anaesthetic groups, respectively. Chi-squared analysis showed concurrent other surgical treatment to be the only statistically significant factor in anaesthetic choice. Conclusions:, Difficulty of canine exposure is not a significant factor in anaesthetic choice for adolescents, other concurrent surgical treatment appears a more significant factor in anaesthetic choice in this group. [source]

Generalized bone loss as a predictor of three-year radiographic damage in African American patients with recent-onset rheumatoid arthritis

ARTHRITIS & RHEUMATISM, Issue 8 2010
Jie Zhang
Objective To examine the association between baseline bone mineral density (BMD) and radiographic damage at 3 years of disease duration in a longitudinal cohort of African Americans with recent-onset rheumatoid arthritis (RA). Methods African American RA patients with a disease duration of <2 years (n = 141) were included in the study. All patients underwent baseline BMD measurements (femoral neck and/or lumbar spine) using dual x-ray absorptiometry. T scores were calculated using normative data from the general population of African Americans. Patients were categorized as having osteopenia/osteoporosis (T score less than or equal to ,1) or as being healthy. Hand and wrist radiographs, obtained at baseline and at 3 years of disease duration, were scored using the modified Sharp/van der Heijde method. The association between baseline BMD and total radiographic score at 3 years of disease was examined using multivariable negative binomial regression. Results At baseline, the mean age and the mean disease duration were 52.4 years and 14.8 months, respectively; 85.1% of the patients were women. The average total radiographic scores at baseline and at 3 years of disease were 2.4 and 5.7, respectively. In the final reduced multivariable model, adjusting for age, sex, anti,cyclic citrullinated peptide antibody positivity, and the presence of radiographic damage at baseline, the total radiographic score at 3 years disease in patients with osteopenia/osteoporosis of the femoral neck was twice that in patients with normal bone density, and the difference was statistically significant (P = 0.0084). No association between lumbar spine osteopenia/osteoporosis and radiographic score was found. Conclusion Our findings suggest that reduced generalized BMD may be a predictor of future radiographic damage and support the hypothesis that radiographic damage and reduced generalized BMD in RA patients may share a common pathogenic mechanism. [source]

Rheumatoid factor is the major predictor of increasing severity of radiographic erosions in rheumatoid arthritis: Results from the Norfolk Arthritis Register Study, a large inception cohort

ARTHRITIS & RHEUMATISM, Issue 4 2002
M. Bukhari
Objective To identify the relative contributions of clinical and laboratory variables, determined at baseline, in predicting the deterioration of radiographic damage 5 years after presentation in patients with inflammatory polyarthritis. Methods Data from 439 subjects who sought primary care for inflammatory polyarthritis were analyzed. All subjects had paired radiographs, of which the first was obtained within 24 months of presentation and the second at 5 years after presentation. The contribution of baseline clinical and laboratory variables in predicting the degree of radiologic severity as judged by the Larsen score was assessed at both time points. Additionally, the role of these factors in predicting change after adjustment for baseline severity was also measured. Results By 5 years, 49% of subjects had evidence of erosions. The median Larsen score on the first film was 2 (interquartile range [IQR] 0,10) and the median score on the followup film was 7 (IQR 1,25). These corresponded to a median deterioration of 3 (IQR 0,14) in all subjects, whereas those subjects with evidence of erosions at first film showed a median deterioration of 15 (IQR 6,29) on followup. The rheumatoid factor (RF) status, C-reactive protein levels, the presence of nodules, and number of swollen joints at baseline were all predictive of radiographic severity at first film. Not surprisingly, the baseline radiographic score was a predictor of severity of deterioration. However, after adjusting for baseline severity, a high titer of RF (>1:160) was also an independent predictor of deterioration over 5 years: individuals with an initial RF at that level had a progression in their Larsen score that was 2.3 times (95% confidence interval 1.7,3.2) higher than that in the RF-negative individuals. Apart from this, only age had an independent effect, after adjusting for baseline severity, in predicting increasing radiographic joint damage. Conclusion High-titer RF is an important variable in predicting continuing severity of radiographic damage during the first 5 years after presentation with inflammatory polyarthritis. [source]

Inter- and intra-observer reliability of radiographic scores commonly used for the evaluation of haemophilic arthropathy

HAEMOPHILIA, Issue 3 2008
M. SILVA
Summary., Although the severity of haemophilic arthropathy is commonly assessed using established radiographic scoring systems, there is limited available information about their inter- and intra-observer reliability. The purpose of the present study was to establish the inter-observer reliability (IEOR) and intra-observer reliability (IAOR) of three different methods available for the classification of haemophilic arthropathy, including the Arnold and Hilgartner classification, a modification to the Arnold and Hilgartner system described by Luck et al., and the classification described by Pettersson et al. Antero-posterior and lateral radiographs of 54 haemophilic joints were included for the analysis. To determine the IEOR for each one of the three radiographic systems, the radiographs were randomly evaluated by four observers, including two orthopaedic surgeons, one orthopaedic resident and one haematologist. For the determination of IAOR, all four reviewers repeated the assessment in a similar fashion, after a period of at least 2 weeks. IEOR and IAOR for the three classification systems was established using kappa (,) statistics. A Spearman rank correlation was used to determine the similarities between each reviewer's own interpretative scales. The IEOR was low for the Arnold and Hilgartner system (, = 0.35, P , 0.001) and the Luck system (, = 0.38, P , 0.001), but even lower for the Pettersson system (, = 0.06, P = 0.1). For the Pettersson system, particularly low , values were observed for the presence or absence of osteoporosis (, = 0.11, P = 0.0027), enlarged epiphysis (, = 0.10, P = 0.0039), erosion of joint margins (, = 0.11, P = 0.0018), and joint deformity (, = 0.16, P = 0.00001). However, a relatively high Spearman rank correlation for all three scales [rs = 0.75 (P < 0.001) for Arnold and Hilgartner system, rs = 0.74 (P < 0.001) for the Luck system and rs = 0.81 (P < 0.001) for Pettersson system] indicated an overall, general agreement among the reviewers with regard to the severity of the haemophilic arthropathy. There was a moderate IAOR value for both, the Arnold and Hilgartner system (, = 0.57, P = 0.00001) and the Luck system (, = 0.62, P = 0.00001) with a low IAOR value for the Pettersson system [, = 0.22, P = 0.00001). Currently available radiographic scoring systems for haemophilic arthropathy have low inter- and intra-observer reliability rates. Improvements, either through education or modification of the scoring systems, are critical in an era where correlations between clinical and radiographic scores have received significant attention. [source]

Reliability and construct validity of the compatible MRI scoring system for evaluation of elbows in haemophilic children

HAEMOPHILIA, Issue 2 2008
A. S. DORIA
Summary., We assessed the reliability and construct validity of the Compatible MRI scale for evaluation of elbows, and compared the diagnostic performance of MRI and radiographs for assessment of these joints. Twenty-nine MR examinations of elbows from 27 boys with haemophilia A and B [age range, 5,17 years (mean, 11.5)] were independently read by four blinded radiologists on two occasions. Three centres participated in the study: (Toronto, n = 24 examinations; Atlanta, n = 3; Cuiaba, n = 2). The number of previous joint bleeds and severity of haemophilia were reference standard measures. The inter-reader reliability of MRI scores was substantial (ICC = 0.73) for the additive (A)-scale and excellent (ICC = 0.83) for the progressive (P)-scale. The intrareader reliability was excellent for both P-scores (ICC = 0.91) and A-scores (ICC = 0.93). The total P- and A-scores correlated poorly (r = 0.36) or moderately (r = 0.54), but positively, with clinical-laboratory measurements. The total MRI scores demonstrated high accuracy for discrimination of presence or absence of arthropathy [P-scale, area-under-the-curve (AUC) = 0.94 ± 0.05; A-scale, AUC = 0.89 ± 0.06], as did the soft tissue scores of both scales (P-scale, AUC = 0.90 ± 0.06; A-scale, AUC = 0.86 ± 0.06). Areas-under-the-curve used to discriminate severe disease demonstrated high accuracy for both P-MRI scores (AUC = 0.83 ± 0.09) and A-MRI scores (AUC = 0.87 ± 0.09), but non-diagnostic ability to discriminate mild disease. Similar results were noted for radiographic scales. In conclusion, both MRI scales demonstrated substantial to excellent reliability and accuracy for discrimination of presence/absence of arthropathy, and severe/non-severe disease, but poor to moderate convergent validity for total scores and non-diagnostic discriminant validity for mild/non-mild disease. Compared with radiographic scores, MRI scales did not perform better for discrimination of severity of arthropathy. [source]

Clinical and radiographic scores in haemophilic arthropathies: how well do these correlate to subjective pain status and daily activities?

HAEMOPHILIA, Issue 6 2002
T. Wallny
Summary. Haemophilic patients who reached adulthood before the establishment of prophylactic treatment frequently show multiple and substantial arthropathies. The aim of this study was to determine to what extent haemophiliac's subjective impairment due to arthropathies correlates with objective clinical and radiographic parameters. By means of a questionnaire and a visual analogue scale, we consulted 79 haemophiliacs concerning their joint-pain status, how these were treated and to what extent their daily activities had been affected. Using a scoring system suggested by the Advisory Committee of the World Federation of Haemophilia, clinical evaluation was performed. Radiographs of 60 patients were assessed by means of the Petterson scale. The results were statistically compared. We found a significant correlation between pain intensity and clinical pathology as well as between pain intensity and radiographic joint damage for both knees and for the right ankle. The number of painful joints correlated well with the number of clinically/radiographically affected joints. The more pronounced the objective damage to joints, the more frequently patients claimed to have constant pain, depressive episodes and a dependency on pain-relieving medication. The more pronounced the objectively assessed damage to the knee and ankle joint, the higher the likelihood that the patient suffers from severe joint pain and reduction of activity. Treatment of painful symptoms from arthropathies is often insufficient. Scores and questionnaires may help to define the haemophiliacs pain status more clearly, thereby offering a possibility of assessment and long-term observation. [source]

Power Doppler sonography in the diagnosis of hemophilic synovitis , a promising tool

JOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 12 2008
S. S. ACHARYA
Summary.,Background:,Recurrent hemarthroses in hemophilia results in synovitis and joint arthropathy. Primary prophylaxis when universally instituted at current doses can prevent joint deterioration but is expensive. Alternatively, the selective implementation of prophylaxis would require a more sensitive tool for detecting synovitis than possible with clinical surveillance or plain radiographs. Magnetic resonance imaging (MRI) is such a tool and is utilized for the evaluation of hemophilic joint disease (HJD). However, it is expensive, and requires sedation in younger children precluding its utility for monitoring of synovitis. Ultrasonography (USG) with power Doppler (USG-PDS) has been utilized to detect and quantitate synovial vascularity in other arthritides and could provide an equally effective but less costly tool for HJD, particularly in children who would not require sedation. Objectives:,To determine whether USG-PDS is comparable to MRI in the evaluation of hemophilic synovitis. Patients:,A prospective cohort of 31 subjects including 33 joints (knees, elbows, ankles) underwent dynamic contrast enhanced (DCE)-MRI and USG-PDS. Results:,USG-PDS measurements of synovial thickness(r = 0.70, P < 0.0001) and synovial vascularity (r = 0.73, P < 0.0001) correlated strongly with those obtained with DCE-MRI. A cutoff of PDS intensity of 1.3 decibels (dB) per mm2 was found to yield a sensitivity of 100% and a specificity of 94.1% in 17 joints with/without a history of hemarthroses. Pettersson radiographic scores correlated significantly with synovial thickness in adults but not children. Conclusions:,Our data suggest that USG-PDS may be an inexpensive and easily implemented imaging tool for detecting hemophilic synovitis and could be useful in tailoring effective prophylaxis. [source]

Amelioration of experimental arthritis by a telomerase-dependent conditionally replicating adenovirus that targets synovial fibroblasts

ARTHRITIS & RHEUMATISM, Issue 11 2009
Shih-Yao Chen
Objective Synovial fibroblasts (SFs) play a pivotal role in the pathogenesis of rheumatoid arthritis (RA). It has been documented that the phenotype of rheumatoid synovium is similar, in many respects, to that of an aggressive tumor. In this study, a novel, genetically engineered adenovirus was designed to lyse SFs that exhibit high telomerase activity and p53 mutations, and its effects as a novel therapeutic strategy were assessed in an experimental arthritis model. Methods An E1B,55-kd,deleted adenovirus driven by the human telomerase reverse transcriptase promoter was constructed (designated Ad.GS1). Cytolysis of SFs and productive replication of Ad.GS1 in the SFs of rats with collagen-induced arthritis (CIA), as well as the SFs of patients with RA (RASFs), were assessed in vitro and in vivo. Treatment responses, as well as the presence of disease-related cytokines and enzymes in the ankle joints, were determined in the murine model. Results Ad.GS1 replicated in and induced cytolysis of human RASFs and SFs from arthritic rats, but spared normal fibroblasts. Bioluminescence imaging in vivo also demonstrated replication of Ad.GS1 in arthritic rat joints, but not in normal rat joints. Intraarticular administration of Ad.GS1 significantly reduced the ankle circumference, articular index scores, radiographic scores, and histologic scores and decreased the production of interleukin-1,, matrix metalloproteinase 9, and prolyl 4-hydroxylase in rats with CIA compared with their control counterparts. Conclusion This study is the first to demonstrate the amelioration of arthritic symptoms by a novel, telomerase-dependent adenovirus in the rat CIA model, an experimental model that resembles human RA. In addition, the results suggest that because of its ability to induce cytolysis of SFs, this virus may be further explored as a therapeutic agent in patients with RA. [source]

Measuring function in rheumatoid arthritis: Identifying reversible and irreversible components

ARTHRITIS & RHEUMATISM, Issue 9 2006
Daniel Aletaha
Objective Measurement of physical function at one point in time cannot distinguish impairment caused by the active disease process from chronic irreversible impairment. We aimed to dissect these two components of functional limitation in rheumatoid arthritis (RA) by using the disability index of the Health Assessment Questionnaire (HAQ) as the measure of function. Methods We performed a secondary analysis of data from 6 contemporary clinical trials of RA (2,763 patients). Patients in whom remission was achieved in the trials, based on a simplified disease activity index, were identified. In an individual patient, HAQ scores at trial entry represented both reversible and irreversible impairments, while HAQ scores at the time of RA remission represented the mostly irreversible component, and the difference between these corresponded to the component related to disease activity. We tested the concept that the HAQ has a reversible and an irreversible component by associating the HAQ score during remission with 2 measures associated with the degree of accrued damage: duration of RA and radiographic severity. Results Among patients in whom clinical remission was achieved (n = 295), average HAQ scores despite clinical remission increased progressively with the duration of RA, from 0.19 (<2 years of RA) to 0.36 (2,<5 years) to 0.38 (5,<10 years) to 0.55 (,10 years) (P < 0.001). The reversibility of HAQ scores decreased with the duration of RA (median 100%, 83.3%, 81.9%, and 66.7%, respectively; P < 0.001). Findings were similar in patients subgrouped by quartile of radiographic scores. Conclusion Differences in the sources of functional limitations should be considered in the interpretation of functional measures, and in their use for prediction and in cost analyses. [source]

Rituximab for rheumatoid arthritis refractory to anti,tumor necrosis factor therapy: Results of a multicenter, randomized, double-blind, placebo-controlled, phase III trial evaluating primary efficacy and safety at twenty-four weeks

ARTHRITIS & RHEUMATISM, Issue 9 2006
Stanley B. Cohen
Objective To determine the efficacy and safety of treatment with rituximab plus methotrexate (MTX) in patients with active rheumatoid arthritis (RA) who had an inadequate response to anti,tumor necrosis factor (anti-TNF) therapies and to explore the pharmacokinetics and pharmacodynamics of rituximab in this population. Methods We evaluated primary efficacy and safety at 24 weeks in patients enrolled in the Randomized Evaluation of Long-Term Efficacy of Rituximab in RA (REFLEX) Trial, a 2-year, multicenter, randomized, double-blind, placebo-controlled, phase III study of rituximab therapy. Patients with active RA and an inadequate response to 1 or more anti-TNF agents were randomized to receive intravenous rituximab (1 course, consisting of 2 infusions of 1,000 mg each) or placebo, both with background MTX. The primary efficacy end point was a response on the American College of Rheumatology 20% improvement criteria (ACR20) at 24 weeks. Secondary end points were responses on the ACR50 and ACR70 improvement criteria, the Disease Activity Score in 28 joints, and the European League against Rheumatism (EULAR) response criteria at 24 weeks. Additional end points included scores on the Functional Assessment of Chronic Illness Therapy,Fatigue (FACIT-F), Health Assessment Questionnaire (HAQ) Disability Index (DI), and Short Form 36 (SF-36) instruments, as well as Genant-modified Sharp radiographic scores at 24 weeks. Results Patients assigned to placebo (n = 209) and rituximab (n = 311) had active, longstanding RA. At week 24, significantly more (P < 0.0001) rituximab-treated patients than placebo-treated patients demonstrated ACR20 (51% versus 18%), ACR50 (27% versus 5%), and ACR70 (12% versus 1%) responses and moderate-to-good EULAR responses (65% versus 22%). All ACR response parameters were significantly improved in rituximab-treated patients, who also had clinically meaningful improvements in fatigue, disability, and health-related quality of life (demonstrated by FACIT-F, HAQ DI, and SF-36 scores, respectively) and showed a trend toward less progression in radiographic end points. Rituximab depleted peripheral CD20+ B cells, but the mean immunoglobulin levels (IgG, IgM, and IgA) remained within normal ranges. Most adverse events occurred with the first rituximab infusion and were of mild-to-moderate severity. The rate of serious infections was 5.2 per 100 patient-years in the rituximab group and 3.7 per 100 patient-years in the placebo group. Conclusion At 24 weeks, a single course of rituximab with concomitant MTX therapy provided significant and clinically meaningful improvements in disease activity in patients with active, longstanding RA who had an inadequate response to 1 or more anti-TNF therapies. [source]

Followup radiographic data on patients with rheumatoid arthritis who participated in a two-year trial of prednisone therapy or placebo

ARTHRITIS & RHEUMATISM, Issue 5 2006
Johannes W. G. Jacobs
Objective In a previous clinical trial of patients with early rheumatoid arthritis (RA), it was determined that patients who received 10 mg of prednisone per day for 2 years had less radiographic joint damage compared with those who received placebo. Our goal was to investigate whether this beneficial effect persisted after the end of the trial. Methods A blinded assessment of radiographic joint damage was performed ,3 years after the end of the original 2-year study. Twenty-four patients from the original prednisone group (60%) and 28 patients from the original placebo group (68%) participated in this followup study. At the end of the original trial, prednisone dosages were tapered down in the prednisone group and stopped, if possible. Patients from the original prednisone group took prednisone during 35% of the followup period (,1 year) at a mean daily dose of ,5 mg. Two patients from the original placebo group started taking prednisone during followup. Radiographs of the hands and feet were scored according to the van der Heijde modification of the Sharp method. Results During 3 additional years of followup, radiographic scores showed significantly less progression in the original prednisone group than in the original placebo group. Radiographic damage in the original prednisone group did not show an accelerated rate of progression during the followup period. Conclusion The inhibition of radiographic joint damage in patients with early active RA treated with 10 mg of prednisone per day for 2 years seems to persist after the end of prednisone therapy. [source]