Objective: To examine the radiographic changes in rheumatoid arthritis (RA) occurring over a 20 year period.
Methods: In 103 patients with recent (< 6 months) seropositive RA, radiographs were taken at onset and at 1, 3, 8, 15, and 20 years from entry. Larsen grades for wrist and subtalar joints were first multiplied by 5, and these together with Larsen grades for the 1st to 5th metacarpophalangeal (MCP) joints, the 1st interphalangeal, and the 2nd to 5th metatarsophalangeal (MTP) joints of the feet (24 joints) were added to form a Larsen score of 0-200. Larsen grades for the 1st to 5th MCP, wrists, and 2nd to 5th MTP (20 joints) were added to form a Larsen score of 0-100.
Results: The means of the 0-200 Larsen score were 4.3, 12.9, 26.9, 55.7, 77.5, and 86.4, and of the 0-100 Larsen score 2.5, 7.0, 13.9, 28.2, 39.4, and 44.5.
Conclusion: Seropositive RA is a chronic disease still leading to continuous progression of joint damage 20 years after onset.