Early and advanced stages in palindromic rheumatism patients: Test characteristics of three classification criteria and discrimination potential

It is to identify the classification characteristics of diagnostic criteria in the early (≤3 year) and advanced stage (>3 year) of palindromic rheumatism (PR). 269 patients of PR were selected out of those with recurrent intermittent arthritis and were divided into two groups with ≤3 year (n = 99) and >3 year (n = 170) disease duration. The clinical characteristics and the positive incidence according to 3 classification criteria: Pasero and Barbieri (1986); Hannonen et al. (1987) and Guerne and Weisman (1992) were compared. Furthermore, the positive incidences of each criterion were calculated. The mean age of the patients was 39.2 ± 10.8 years and M:F 1.2:1. The agreement of the Hannonen et al. (1987) and Guerne and Weisman (1992) criteria was the highest with 0.63 of κ value. When the positive incidences by each criteria were compared between groups of the ≤3 year and >3 year, both Hannonen et al criteria (76.8% and 91.2%) and Guerne and Weisman (62.6% and 85.8%) were significantly different (p = 0.001). The criterion that showed the obvious difference between early and advanced stages were as follow: (Pasero and Barbieri) >5 attacks in the last 2 years and ≥3 joints involved in different attacks; (Hannonen et al.) subsequent attacks in at least three different joints and for (Guerne and Weisman) six-month history of brief-sudden-onset and recurrent episodes of monoarthritis and ≥3 joints involved in different attacks. The individual PR criteria showed different classification characteristics in ≤3 year and >3 year.