These patients have typical symmetric joint pain, hardly erosions of the MCP or PIP joints, but radiographic destruction of the dominant hand's wrist. I haven't found anything in the literature on this particular phenomenon. Have others similar patients?
I Have noted this pattern of arthritis as well and call it hinge joint rheumatoid. The patients are invariably ACPA positive, but the RF weakly positive or negative. They often go on to develop bilateral changes and involvement of ankles and subtalar joints (over many years). They are often women and non-smokers.
Yes indeed.
Two patients with severe RA of the wrist and hand and one patient with SLE accompanied by destruction of the joints with positive A-CCP were monitored in my hand clinic. Patients with this positive marker and clinical signs are suitable for the determination of RA and SLE. The test also indicates aggressive disease and a less favorable prognosis.
Nevertheless, today I examined new patient with a positive A-CCP but without any appropriate signs for RA. In this case it is not possible to determine that he is suffering from RA and it is necessary to return to the test and clinical examination several times and the patient must still show typical signs of RA for at least 6 consecutive weeks to determine the diagnosis.
Thanks for your experience! Do you have any literature on this? If not, why don't we combine our case for a small case series?
- Badges
- Science topic
- Similar topics
- Biological Science
- Immunology
- Antibodies