Analysis Of Rheumatoid Arthritis Diagnosis Between New And Old Standard Comparison

ObjectiveRheumatoid arthritis (RA) is a chronic, symmetrical polyarthritis as the maincharacteristics, for unknown reasons, changes in systemic inflammatory autoimmunediseases. Erosive arthritis is the main characteristics, which is one of the main causes of thejoints disability. Therefore, early diagnosis and early treatment of RA is the most urgentthing for contemporary rheumatologist physicians. At present, the clinical diagnosis ofRA is adopted in the widely familiar American Rheumatism Association (ACR)classification standard of1987, In accordance with4of all the Article and the symptomslasted for more than6weeks. But the limitations was found with the progress of laboratorytest, radiographic and the demand for early RA diagnosis in clinical work. In2010, ACRand the European League Against Rheumatism (EULAR) formulated the new RAclassification standards. To diagnosis of RA with this standard is according to the integralof affected joints, serum antibody test results, the acute phase reactant, the duration of thesymptoms and other projects. So, how are the sensitivity and specificity of old and newstandard for the diagnosis of RA. Will lead to misdiagnosis rate increases due to increasedsensitivity or lead to delay the best treatment opportunity due to specificity is extremelyhigh and the duration is already late. In order to understand the clinical course of RA, clearthe value in early diagnosis and early treatment of RA, we analysised the data of thepatients with arthritis, who are hospitalized in our department in May2009-May2010,;udied the Clinical manifestations, check index of serology inflammation, rheumatoid factor,anti-cyclic citrullinated peptide antibody and imaging characteristics of early RA;Comparative analysis ed the old and new diagnostic criteria.MethodsPatients who were charged were aged>20, the duration <1year, and were clearly dignosed of RA. We asked the history, recorded he clinical manifestation, gived thephysical examination; recorded the joint swelling and pain site, symmetry, duration, timeof morning stiffness, subcutaneous nodules, and other things. Monitoring of platelet inserum (PLT), erythrocyte sedimentation rate (ESR), C reactive protein (CRP), the value ofanti-cyclic citrullinated peptide (CCP), rheumatoid factor (RF), immunoglobulin index,And record the joint imaging characteristics. Diagnosed by the rheumatology specialist.The undiagnosed patients were asked to followed-up for every March until1years.Analysis all of the index, and diagnostic criteria for comparison, used t test, x2test wereused for statistical analysis.Results①A total of105patients with arthritis duration <1example, after1years offollow-up,70cases were diagnosed as RA,25cases were diagnosed as other rheumaticdiseases,10cases have not yet confirmed.②Analysis of early RA diagnosis sensitivity orspecificity high index.③The1987American College of Rheumatology (ACR)classification standard and ACR/2010European League Against Rheumatism (EULAR)classification standard, the sensitivity of55.2%, specificity of90.2%, the latter82.1%sensitivity,81.5%specificity.VerdictThe classification standard of1987is not suitable for the early diagnosis of RA,compared with the1987standard, the sensitivity of the2010criteria is higher, but thespecificity is low, can be screened out early rheumatoid arthritis patients as much aspossible, and its inadequacies in seronegative arthritis symmetry and the misdiagnosis ofself-limited the rate of increase of arthritis. And there is still a certain number of misseddiagnosis.