Jun 13, 2015 - Preventive Medicine, Catholic University of Daegu School of Medicine;. 4Department of Internal Medicine, Arthritis & Autoimmunity Research ...
Scientific Abstracts
Saturday, 13 June 2015
773
criteria could improve the reproducibility of US among sonographers and promote a greater diffusion of ultrasound as a diagnostic tool for the diagnosis of CPPD. Disclosure of Interest: None declared DOI: 10.1136/annrheumdis-2015-eular.5968
SAT0316
VALIDATION OF NOVEL SIMPLIFIED RADIOGRAPHIC DAMAGE INDEX FOR AFFECTED JOINTS IN CHRONIC GOUT ARTHRITIS: A PRELIMINARY PROPOSAL
C.-N. Son 1 , T.E. Kim 2 , K. Park 2 , J.H. Hwang 3 , J.-Y. Choe 4 , S.-K. Kim 4 . Department of Internal Medicine, Keimyung University Dongsan Medical Center; 2 Department of Radiology, Daegu Fatima Hospital; 3 Department of Preventive Medicine, Catholic University of Daegu School of Medicine; 4 Department of Internal Medicine, Arthritis & Autoimmunity Research Center, Catholic University of Daegu School of Medicine, Daegu, Korea, Republic Of 1
Background: The evaluation of radiographic damage in inflammatory arthritis has been considered important, because structural damage of affected joints impairs the functional status of patients with various inflammatory rheumatic diseases and increases their economic problems and mortality [1, 2]. However, there has still been no relevant radiographic index for damage of affected joints in patients with chronic gouty arthritis. Modified SvdH scoring method has been proposed to be an alternative method [3], however, it seems to be so complex and also lack of relevance to use in clinical practice. Objectives: The aim of this study was to develop and validate more a simple method to score radiographic damage measurement in patients with chronic gout. Methods: Two independent observers read foot x-rays using the DAmagE index of GoUt score method (DAEGU score) and the modified Sharp/van der Heijde (SvdH) method. The 10 metatarsophalangeal (MTP) and 2 interphalangeal (IP) joints of the first toes of both feet from 15 patients with chronic gout were scored on plain radiography for erosion and joint space narrowing (JSN) (180 total joints). The intraobserver and interobserver reliability were analyzed by intraclass correlation coefficient (ICC) and minimal detectable change (MDC). The correlation between the DAEGU and SvdH methods was analyzed using Spearman’s correlation coefficients and Kappa coefficients. Results: The intraobserver and interobserver ICCs for the DAEGU method were 0.945–0.987 and 0.993–0.996, respectively. The MDC at the 95% confidence interval (MDC95) showed 0.5–2.1 and 0.3–0.7 in the intra- and interobserver analyses, respectively. Strong positive correlations were represented between the DAEGU and SvdH methods for each radiological abnormality including erosion, JSN, and total score (correlation coefficients: r =0.870–0.985, p0.05); also, women had more tophi at the distal and proximal interphalangeal joints than men. Table 1. Comparison of features of gout in women and men Variables Mean age (years) Clinical presentation
Fever Elevated uric acid level Inflammatory response Urate cristal (synovial fluid) Urate Arthropathies Tophi Current medical conditions
Chronic gout Monoarticular Oligoarticular Polyarticular
Elevated CRP Elevated ESR
Hypertension Diabetis Dyslipidemia Chronic renal disease Heart failure Diuretics Low dose aspirin
Women (n=96)
Men (n=415)
P value
63±11.0 55 41 52 3 3 56 32 56 8 10 10 53 15 7 3 3 15 2
54±10.2 201 214
0.001 >0.05 >0.05 143 58 0.02 0.001 >0.05 >0.05 0.01 >0.05 0.05 0.001 0.12 0.06 0.12 0.04 0.01 0.03
18 201 132 195 14 58 193 155 37 31 39 13 36 4
Conclusions: Gout in women seems to present specific characteristics. Further studies are needed to better understand these differences Disclosure of Interest: None declared DOI: 10.1136/annrheumdis-2015-eular.5841
