The British Journal of Rheumatology, Vol 36, 225-228, Copyright © 1997 by British Society for Rheumatology
JR Kirwan
If clinically evident synovitis causes erosions, then the two should be
highly correlated within individual joints. Separate hand joints (total
2064) were examined for the presence of synovitis (the simultaneous
presence of soft-tissue swelling and tenderness) on nine occasions over 2
yr. The cumulative synovitis score was compared to the change in the Larsen
score over the same period. The mean correlation between synovitis and
erosion progression was r = 0.248 (explained variance = 6%). Of the 216
joints which showed progressive X-ray damage, 44% had a cumulative
synovitis score of < 3. When all the joints of one hand were taken
together, the correlation was increased to r = 0.418 and for all the joints
of both hands taken together it was further increased to r = 0.424. These
results argue against there being a direct causal relationship between
clinically inflamed synovitis and erosions in rheumatoid arthritis, and
question the assumption that erosions and the signs of synovitis represent
the same pathological process.
ORIGINAL PAPERS
The relationship between synovitis and erosions in rheumatoid arthritis
University Department of Medicine, Bristol Royal Infirmary.
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