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Technique for detecting early rheumatoid arthritis.

The authors are of the opinion that the controversy surrounding the value of radiography in the early diagnosis of RA and subsequent assessment of drug therapy is due to the poor resolution of the radiographs used in many of these studies. Given that radiographic findings correlate with the pathological changes occurring in the hands and wrists of the RA patient, the ARA 1987 revised criteria for the classification of RA requires a PA projection of the hands and wrists. With this in mind, it is obvious that a standard radiographic technique offering high-resolution be developed and implemented. Direct magnification procedures as previously described offer high-resolution, however, they are either too cumbersome to use, require specialized, limitedly available equipment, produce partial images, have prolonged exposure times leading to part motion and are too expensive. In addition, radiation dosages to the skin are higher. These problems also preclude their use in the establishment of screening procedures for early RA. By comparison, the authors' optical magnification technique eliminates the major problems encountered in direct magnification. More importantly, the described optical magnification technique provides high-resolution radiographs utilizing readily available equipment and offers a practical means for the effective screening and diagnosis of early RA.