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Adapted CT technology enhanced detection of bone erosions in RA patients
A novel computed tomography imaging technique improved erosion detection and yielded reproducible periarticular bone microstructure measurements in patients with rheumatoid arthritis, according to recent study results.
Researchers in Canada performed high-resolution peripheral quantitative computed tomography (HR-pQCT) on 15 patients with rheumatoid arthritis (RA; mean age, 46.4 years; 87% women) and 15 matched controls without RA. Determining voxels between 3-D images of the articular surfaces was used to calculate joint space width. Standard analysis quantified periarticular bone microstructure for the second and third metacarpophalangeal (MCP) joints. Viewing 2-D and 3-D images of joints confirmed erosion presence.
“Quantitative measures of joint space width and periarticular bone microstructure were obtained with precision,” the researchers reported.
Although detecting differences in joint space width between patients with RA and controls was not the primary outcome, there was a trend in significant narrowing in the RA patients at the second MCP joints (mean difference, 250 mcm; P=.057). HR-pQCT found erosions in all RA patients, with an average of 23.6 (standard deviation [SD] 17.5) erosions over 10 joints imaged. Erosions were found in nine control participants, with a mean erosion count of 3.6 (SD 5.2). RA erosions occurred most frequently at the metacarpal head of the MCP joint, while control participants’ erosions were located at proximal interphalangeal (PIP) joints.
Compared with standard radiography, HR-pQCT identified erosions in 24.7% more joints.
“This is the first study to exploit the quantitative capabilities of HR-pQCT to provide joint space width measurements at the MCP and PIP joints,” the researchers concluded.
“We propose methodology for quantifying joint space width in RA, an important consideration for functional outcomes. HR-pQCT imaging shows great promise in its potential to measure bone damage parameters in RA.”