Healing phenomena of erosive changes in rheumatoid arthritis patients undergoing disease-modifying antirheumatic drug therapy

Objective. To describe radiographic healing phenomena and reparative changes of joint destruction in rheumatoid arthritis (RA). Methods. Serial radiographs of 6 patients with erosive RA undergoing long-term treatment with disease-modifying antirheumatic drugs (DMARDs) were studied, Radiographs showing healing phenomena were reproduced, and examples of single joints are shown. Results. The examples show recortication of erosions, filling in of erosions with new bone, and secondary osteoarthrosis with bone sclerosis and osteophyte formation, Commonly used radiographic scoring methods do not have the capacity to account for these reparative changes. Conclusion. Healing phenomena can be observed in RA patients undergoing long-term DMARD treatment, These phenomena can be regarded as clinical end points, and their assessment should be incorporated into existing standardized methods for radiologic evaluation and scoring of RA.