Affiliations: [a] Rehabilitation Medicine Department, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, MD, USA | [b] Arthritis and Rheumatism Branch, National Institute of Arthritis, Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA
Correspondence:
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Correspondence to: Lynn Gerber, M.D., National Institutes of Health, Bldg. 10, RM 6S235, 10 Center Dr MSC 1604, Bethesda, MD 20892-1604, USA. Tel.: +1 301 496 4733; Fax: +1 301 402 0663; E-mail: lgerber@nih.gov.
Abstract: The biological, physical and functional status change was measured in 104 patients with recent (<1 year) onset synovitis. Measurements were taken initially and at 1 year. The purpose was to determine which biological and physical measures correlated with poor performance. Patients completed questionnaires quantifying activity, (the Human Activity Profile [HAP] and Sickness Impact Profile [SIP]), pain (Wisconsin Brief Pain Inventory), fatigue (Multidimensional Assessment of Fatigue), sleep, and mood (POMS and CES-D). They were evaluated for articular involvement (Ritchie Index) and biological markers of disease activity (platelets, sedimentation rate, C-reactive protein and rheumatoid factor) (RF). In all, 30 men and 74 women participated. A total of 45 patients met the American College of Rheumatology criteria for rheumatoid arthritis (RA); of these, 24 were rheumatoid factor (RF) positive, 18 had spondylitis, and 41 had unclassified arthritis. Low activity level at 1 year (HAP and SIP) correlated with high numbers of inflamed joints initially (p<0.002); with more than 10 involved joints regardless of diagnostic groupp=0.001); and joint symmetry (p<0.009) A high platelet count was associated with low activity level at 1 year (p=0.01); and high sedimentation rate was associated with more pain (p<0.05). Low activity level (p<0.04), fatigue (p=0.03) and sleeplessness (p=0.02) were correlated with RF+ RA.
