TY - JOUR
T1 - Assessment of cortical interruptions in the finger joints of patients with Rheumatoid Arthritis using HR-pQCT, radiography, and MRI
AU - Peters, Michiel
AU - van Tubergen, Astrid
AU - Scharmga, Andrea
AU - Driessen, Annemariek
AU - van Rietbergen, Bert
AU - Loeffen, Daan
AU - Weijers, Rene
AU - Geusens, Piet
AU - van den Bergh, Joop
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Small cortical interruptions may be the first sign of an erosion, and more interruptions can be found in patients with rheumatoid arthritis (RA) compared with healthy subjects. First, we compared the number and size of interruptions in patients with RA with healthy subjects using high-resolution peripheral quantitative CT (HR-pQCT). Second, we investigated the association between structural damage and inflammatory markers on conventional radiography (CR) and MRI with interruptions on HR-pQCT. Third, the added value of HR-pQCT over CR and MRI was investigated. The finger joints of 39 patients with RA and 38 healthy subjects were examined through CR, MRI, and HR-pQCT. CRs were scored using the Sharp/Van der Heijde method. MRI images were analyzed for the presence of erosions, bone marrow edema, and synovitis. HR-pQCT images were analyzed for the number, surface area, and volume of interruptions using a semiautomated algorithm. Descriptives were calculated and associations were tested using generalized estimating equations. Significantly more interruptions and both a larger surface area and the volume of interruptions were detected in the metacarpophalangeal joints of patients with RA compared with healthy subjects (median, 2.0, 1.42 mm2, and 0.48 mm3 versus 1.0, 0.69 mm2, and 0.23 mm3, respectively; all p < 0.01). Findings on CR and MRI were significantly associated with more and larger interruptions on HR-pQCT (prevalence ratios [PRs] ranging from 1.03 to 7.74; all p < 0.01) in all subjects, and were consistent in patients with RA alone. Having RA was significantly associated with more and larger interruptions on HR-pQCT (PRs, 2.33 to 5.39; all p < 0.01), also after adjustment for findings on CR or MRI. More and larger cortical interruptions were found in the finger joints of patients with RA versus healthy subjects, also after adjustment for findings on CR or MRI, implying that HR-pQCT imaging may be of value in addition to CR and MRI for the evaluation of structural damage in patients with RA.
AB - Small cortical interruptions may be the first sign of an erosion, and more interruptions can be found in patients with rheumatoid arthritis (RA) compared with healthy subjects. First, we compared the number and size of interruptions in patients with RA with healthy subjects using high-resolution peripheral quantitative CT (HR-pQCT). Second, we investigated the association between structural damage and inflammatory markers on conventional radiography (CR) and MRI with interruptions on HR-pQCT. Third, the added value of HR-pQCT over CR and MRI was investigated. The finger joints of 39 patients with RA and 38 healthy subjects were examined through CR, MRI, and HR-pQCT. CRs were scored using the Sharp/Van der Heijde method. MRI images were analyzed for the presence of erosions, bone marrow edema, and synovitis. HR-pQCT images were analyzed for the number, surface area, and volume of interruptions using a semiautomated algorithm. Descriptives were calculated and associations were tested using generalized estimating equations. Significantly more interruptions and both a larger surface area and the volume of interruptions were detected in the metacarpophalangeal joints of patients with RA compared with healthy subjects (median, 2.0, 1.42 mm2, and 0.48 mm3 versus 1.0, 0.69 mm2, and 0.23 mm3, respectively; all p < 0.01). Findings on CR and MRI were significantly associated with more and larger interruptions on HR-pQCT (prevalence ratios [PRs] ranging from 1.03 to 7.74; all p < 0.01) in all subjects, and were consistent in patients with RA alone. Having RA was significantly associated with more and larger interruptions on HR-pQCT (PRs, 2.33 to 5.39; all p < 0.01), also after adjustment for findings on CR or MRI. More and larger cortical interruptions were found in the finger joints of patients with RA versus healthy subjects, also after adjustment for findings on CR or MRI, implying that HR-pQCT imaging may be of value in addition to CR and MRI for the evaluation of structural damage in patients with RA.
KW - BONE MICROARCHITECTURE
KW - CORTICAL INTERRUPTIONS
KW - HIGH-RESOLUTION PERIPHERAL QUANTITATIVE COMPUTED TOMOGRAPHY
KW - MAGNETIC RESONANCE IMAGING
KW - RADIOGRAPHY
KW - RHEUMATOID ARTHRITIS
KW - Bone Density
KW - Humans
KW - Middle Aged
KW - Cortical Bone/diagnostic imaging
KW - Tomography, X-Ray Computed
KW - Finger Joint/diagnostic imaging
KW - Magnetic Resonance Imaging
KW - Arthritis, Rheumatoid/diagnostic imaging
UR - http://www.scopus.com/inward/record.url?scp=85052504217&partnerID=8YFLogxK
U2 - 10.1002/jbmr.3466
DO - 10.1002/jbmr.3466
M3 - Article
C2 - 29750836
AN - SCOPUS:85052504217
SN - 0884-0431
VL - 33
SP - 1676
EP - 1685
JO - Journal of Bone and Mineral Research
JF - Journal of Bone and Mineral Research
IS - 9
ER -
