Comparison of functional disability scales and their relevance to radiological progression in patients with rheumatoid arthritis in remission

OBJECTIVE: To look for any correlations between radiological scores and hand functions evaluated with two different methods in patients with rheumatoid arthritis in remission. METHODS: Forty-two patients diagnosed with rheumatoid arthritis (RA) in remission according to ACR criteria were assessed for their hand functions with Duru?z's Hand Index (DHI), and with Sollerman Function Test (SHFT) as well as with Health Assessment Questionnaire (HAQ). Hand X-rays were evaluated according to Modified Sharp Index; joint space narrowing score (JSNS), erosion score (ES), and total score (TS) were calculated. The X-rays were assessed by the same rheumatologist three times. RESULTS: Mean HAQ score, mean DHI score and mean SHFT scores were 0.88+/-0.68, 17.74+/-17.81, 72.24+/-9.23 respectively. Radiologic scores were as follows: JSN 35.04+/-28.14, ES 25.19+/-36.23, TS 60.26+/-66.21. Intraobserver reliability was high (r=0,98). There was a positive correlation between HAQ and DHI (p<0.001), a negative correlation between SHFT. There was also a negative correlation between DHI and SHFT. The correlations between JSNS, ES and TS with respect to HAQ and SHFT were strong (p<0.0001) along with DHI (p<0.05). CONCLUSION: HAQ was found correlated with DHI and SHFT. Modified Sharp scores were found correlated with the general disability and hand functions. SHFT, with respect to DHI, takes a longer period of time, depends on equipment and needs an observer. On the contrary, DHI offers a more practical and economical way of assessment.