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Rheumatology Advance Access originally published online on March 31, 2003
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Rheumatology 2003; 42: 919-923
© 2003 British Society for Rheumatology

Editorial

Joint counts in routine practice

D. L. Scott, C. Antoni1, E. H. Choy and P. C. L. M. van Riel2

Department of Rheumatology, GKT School of Medicine, King's College Hospital (Dulwich), East Dulwich Grove, London SE22 8PT, UK,
1 Department of Internal Medicine III, Institute for Clinical Immunology and Rheumatology, University of Erlangen-Nuremberg, Erlangen, Germany and
2 Department of Rheumatology, University Medical Centre, Nijmegen, The Netherlands

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Swollen and tender joints are the most characteristic features of rheumatoid arthritis (RA) and disease severity is directly related to the numbers of swollen and tender joints. Consequently, clinical trials of disease-modifying anti-rheumatic drugs and biologicals use reductions in swollen and tender joint counts as key outcome measures. Despite their central place in RA, we believe that joint counts are not always recorded in specialist clinical care. Our purpose in this editorial is to make the case for their invariable adoption in routine practice.

Counting the number of swollen joints is a clinical method of quantifying the amount of inflamed synovial tissue. Joint tenderness, by contrast, is more closely associated with the amount of pain. As the relationship between joint swelling and tenderness varies from case to case and time to time in the same patient, it is traditional to assess them both. There is no existing consensus on a . . . [Full Text of this Article]


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