scholarly journals Topography of Bone Erosions at the Metatarsophalangeal Joints in Rheumatoid Arthritis: Bilateral Mapping by Computed Tomography

Cureus ◽  
2021 ◽  
Author(s):  
Paolo Simoni ◽  
Sakina Moussaddykine ◽  
Olivier Malaise ◽  
Selma Ben Mustapha ◽  
Maria Pilar Aparisi Gómez ◽  
...  
2016 ◽  
Vol 43 (10) ◽  
pp. 1914-1920 ◽  
Author(s):  
Andrea Scharmga ◽  
Michiel Peters ◽  
Astrid van Tubergen ◽  
Joop van den Bergh ◽  
Cheryl Barnabe ◽  
...  

Objective.Conventional radiographs (CR) of the hands are the gold standard for imaging bone erosions. The presence of bone erosions, reflected by the presence of cortical breaks, is a poor prognostic factor in patients with rheumatoid arthritis (RA). The availability of high-resolution peripheral quantitative computed tomography (HR-pQCT) enables detailed investigation of cortical breaks in rheumatic diseases. The aim of this image review is to show HR-pQCT images of the spectrum of cortical breaks with and without underlying trabecular bone changes in metacarpophalangeal (MCP) joints of healthy controls (HC) and patients with RA, with corresponding images on CR and magnetic resonance imaging (MRI).Methods.Second and third MCP joints of 41 patients (of which 10 were early RA with ≤ 2 years and 24 longstanding RA with ≥ 10 years of disease duration) and 38 HC were imaged by CR, MRI, and HR-pQCT (XtremeCT1, Scanco Medical AG). Representative images of the spectrum of cortical breaks were selected.Results.Cortical breaks were found in early and longstanding RA, but also in HC. They were heterogeneous in size, location, and number per joint, with a variety of surrounding cortical and underlying trabecular bone characteristics.Conclusion.Using HR-pQCT images of MCP joints, heterogeneous cortical breaks with and without surrounding trabecular bone changes were found, not only in RA but also in HC. The underlying mechanisms and significance of this spectrum of cortical breaks as found with high 3-D resolution needs further investigation.


2013 ◽  
Vol 40 (4) ◽  
pp. 408-416 ◽  
Author(s):  
Waraporn Srikhum ◽  
Warapat Virayavanich ◽  
Andrew J. Burghardt ◽  
Andrew Yu ◽  
Thomas M. Link ◽  
...  

Objective.To develop novel quantitative and semiquantitative bone erosion measures at metacarpophalangeal (MCP) and wrist joints in patients with rheumatoid arthritis (RA) using high-resolution peripheral quantitative computed tomography (HR-pQCT), and to correlate these measurements with disease duration and bone marrow edema (BME) patterns derived from magnetic resonance imaging (MRI).Methods.Sixteen patients with RA and 7 healthy subjects underwent hand and wrist HR-pQCT and 3-Tesla MRI. Bone erosions of the MCP2, MCP3, and distal radius were evaluated by measuring maximal erosion dimension on axial slices, which is a simple and fast measurement, and then were graded (grades 0–3) based on the maximal dimension. Correlation coefficients were calculated between (1) sum maximal dimensions, highest grades, and sum grades of bone erosions; (2) erosion measures and the clinical evaluation; (3) erosion measures and BME volume in distal radius.Results.The inter- and intrareader agreements of maximal erosion dimensions were excellent (intraclass correlation coefficients 0.89, 0.99, and root mean square error 9.4%, 4.7%, respectively). Highest grades and sum grades were significantly correlated to sum maximal dimensions of all erosions. Number of erosions, sum maximal erosion dimensions, highest grades, and sum grades correlated significantly with disease duration. Number of erosions, sum maximal dimensions, and erosion grading of the distal radius correlated significantly with BME volume.Conclusion.HR-pQCT provides a sensitive method with high reader agreement in assessment of structural bone damage in RA. The good correlation of erosion measures with disease duration as well as BME volume suggests that they could become feasible measures of erosions in RA.


2015 ◽  
Vol 34 (7) ◽  
pp. 1181-1186 ◽  
Author(s):  
G. Peluso ◽  
S. L. Bosello ◽  
E. Gremese ◽  
L. Mirone ◽  
F. Di Gregorio ◽  
...  

2020 ◽  
pp. jrheum.200286
Author(s):  
Julien Grosse ◽  
Edem Allado ◽  
Éliane Albuisson ◽  
Audrey Pierreisnard ◽  
Marion Couderc ◽  
...  

Objective To evaluate the relationship between the UltraSound Score for Erosions (USSe) and the modified Sharp/van der Heijde score for erosions (SHSe). Methods One hundred eight patients with rheumatoid arthritis (RA) were included. On radiography, SHSe was evaluated by 2 or 3 blinded readers (in case of discordance). On ultrasonography, erosions were scored on 6 bilateral joints (metacarpophalangeal joints 2,3,5; metatarsophalangeal joints 2,3,5) with a 4-point scale to calculate the USSe. Results The Pearson correlation was good (r = 0.68, P < 0.001) and the agreement illustrated by a Bland‑Altman plot was excellent (91%) between the 2 scores, which were complementary in detecting erosions. Conclusion The USSe seems to be a valuable tool for assessing erosive damage in RA.


2008 ◽  
Vol 10 (1) ◽  
pp. R25 ◽  
Author(s):  
Uffe Døhn ◽  
Bo J Ejbjerg ◽  
Maria Hasselquist ◽  
Eva Narvestad ◽  
Jakob Møller ◽  
...  

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