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Chiropractic Research Review

Evaluating Progression and Severity of Arthritis:

Radiography has traditionally been considered the most objective measurement technique for assessing the severity and progression of rheumatoid arthritis (RA). Variations in x-ray evaluation techniques may account for diagnostic inconsistency and clinical inaccuracies.

Three skeletal radiologists evaluated the baseline and 12-month radiographs (scored in terms of erosion and damage) of 284 patients suffering from rheumatoid arthritis, using three different methods: single readings (reading a patient's x-rays one at a time, without knowing the patient or the chronological sequence); paired readings (reading a patients x-rays in pairs, aware that both were from the same patient, but blind as to the sequence); and chronologically ordered paired readings.

The three procedures were then compared in terms of their potential for clinical accuracy. Results suggest that paired readings are the most appropriate for assessing the progression of joint erosion and damage. Doctors of chiropractic should take these findings into account when evaluating the radiographs of patients suffering from rheumatoid arthritis.

Ferrara R, Priolo F, Cammisa M, et al. Clinical trials in rheumatoid arthritis: methodological suggestions for assessing radiographs arising from the GRISAR study. Annals of the Rheumatic Diseases, 1997;56(10), pp608-612.

Chiropractic Research Review

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