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2016 ; 68
(8
): 1201-5
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Using Dermal Temperature to Identify Rheumatoid Arthritis Patients With
Radiologic Progressive Disease in Less Than One Minute
#MMPMID26663265
Greenwald M
; Ball J
; Guerrettaz K
; Paulus H
Arthritis Care Res (Hoboken)
2016[Aug]; 68
(8
): 1201-5
PMID26663265
show ga
OBJECTIVE: To explore development of a screening test for rheumatoid arthritis
(RA) patients most likely to develop radiographic damage in the next year. The
test is a simple, objective measurement of elevated dermal temperature over an
inflamed joint in this observational, prospective cohort study. METHODS:
Seropositive RA patients were sequentially enrolled into cohorts with hot or cool
joints, as determined by a dermal thermometer. Patients naive to biologic therapy
were maintained on a stable dosage of methotrexate (20-25 mg/week). The hot-joint
cohort had a joint skin temperature greater than their body temperature on vital
signs. Hand/wrist radiographs obtained at baseline and 1 year later were read and
scored using modified Sharp/van der Heijde scores (SHS) by a single reader
without sequence order or identifiers. RESULTS: Each cohort consisted of 104
patients enrolled into observation between 2009 and 2014. Patients in the cohort
with hot joints had a mean?±?SD joint temperature of 1.06?±?0.69°F above central
body temperature and a nearly 4-fold higher risk of new radiographic damage than
those with cool joints (SHS score 8.7?±?6.2 versus 2.5?±?1.4; P?0.001).
Sensitivity and specificity for joint temperature to predict radiographic damage
in the next year were 92% and 78%, respectively, in the hot-joint cohort. As
expected, this cohort at baseline was younger, had more recent onset RA, and had
higher Westergren erythrocyte sedimentation rate levels than the cool-joint
cohort (P?0.001 for each). CONCLUSION: Dermal joint temperature may become a
screening test to quickly and accurately identify individual RA patients at high
risk for radiographic damage and those who may benefit most from biologic
therapy.