Disease activity indexes in rheumatoid arthritis; a prospective, comparative study with thermography.

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Abstract
There are many difficulties associated with the assessment of disease activity in rheumatoid arthritis. Infrared thermography was used to quantify joint inflammation. The heat distibution index (HDI) was reproducible, sensitive, quantifiable and not subject to circadian variation or interobserver error. The HDI for both elbows, wrists, knees and ankles were summated and compared with other parameters of disease activity. There were 167 sets of observations in 20 patients with classical, seropositive, rheumatoid arthritis followed up over 12 mo. There was a significant correlation (P < 0.001) for thermography with the Ritchie articular index, Mallaya score, grip strength, morning stiffness, erythrocyte sedimentation rate and pain score. Significant correlations (P < 0.05) for thermography with these parameters were found in individual patients. The summated HDI is a suitable, objective method for the assessment of response to therapy in patients with rheumatoid arthritis.