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The Temporal Relationship of Raynaud's Phenomenon and Features of Connective Tissue Disease in Rheumatoid Arthritis JANET E. POPE, JAMAL AL-BISHRI, HAFSAH AL-AZEM, and JANINE M. OUIMET
ABSTRACT. Methods. Using a standardized assessment, data were collected on 328 subjects with RA [mean age 60.3 ± 0.7; 77% women; 76% erosions, 75% positive rheumatoid factor (RF)] seen at one London, Ontario, rheumatology clinic. The data included RA disease duration; presence and duration of RP; presence of nodules, joint damage, telangiectasia, and sclerodactyly; and RF status (+/-), RF value, antinuclear antibodies, and E-nuclear antibodies. Results. The mean RA disease duration was 12 ± 0.6 years. Seventy-one (22%) had RP and the mean RP duration was 9.2 ± 1.5 years. Patients presented with RP a mean of 3.8 ± 1.4 years after the diagnosis of RA. RP status was positively associated with the presence of sclerodactyly (p < 0.001), but not nodules or erosions. Higher RF values were associated with longer RA disease duration (p < 0.002) and longer RP duration (p < 0.01). Conclusion. Idiopathic RP may have a different clinical effect on RA than secondary RP; the latter is correlated with more severe RA. Sclerodactyly is associated with erosive arthritis and RP in RA. Higher RF values were indicative of increased RA and RP duration. (J Rheumatol First Release Oct 1 2008) Key Indexing Terms:
RAYNAUD'S PHENOMENON
From the Division of Rheumatology, Department of Medicine, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada. J.E. Pope, MD, MPH, FRCPC; J. Al-Bishri, MD; H. Al-Azem, BSc (Hons); J.M. Ouimet, MSc, Division of Rheumatology, Department of Medicine, Schulich School of Medicine and Dentistry, The University of Western Ontario. Address reprint requests to Dr. J.E. Pope, St. Joseph's Health Care London, 268 Grosvenor Street, Box 5777, London, ON N6A 4V2. E-mail: janet.pope@sjhc.london.on.ca Accepted for publication July 11, 2008.
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