Is decreased volar tilt and radial length a sign of early rheumatoid arthritis?

The aim of our study was to evaluate the effect of anatomical measurements consisting of volar tilt, radial length, radial inclination, and ulnar variance obtained from X-ray radiography in predicting deformity in patients with rheumatoid arthritis and the power of these measurements in predicting rheumatoid arthritis in patients with nonspecific wrist pain. A total of 98 rheumatoid arthritis and 40 control patients presenting with nonspecific wrist pain were cross-sectionally evaluated by X-ray radiography. Rheumatoid arthritis patients were divided into subgroups with and without deformity. Volar tilt, radial length, radial inclination, and ulnar variance measurements were performed. When the anatomical measurements of rheumatoid arthritis patients with and without wrist deformity were compared with the control group, volar tilt and radial length were significantly lower in rheumatoid arthritis patients with and without wrist deformity than in the control group. There was no difference between rheumatoid arthritis groups with and without deformity. Low volar tilt and radial length may be an early X-ray radiographic finding of rheumatoid arthritis and may provide additional diagnostic data in patients presenting with nonspecific wrist pain, especially for seronegative rheumatoid arthritis where diagnosis is difficult.