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Anari H, Enteshari-Moghaddam A, Pourfarzi F, Ramazani N. Diagnostic value of Ultrasonography in the detection of Bone Erosions in patients with Rheumatoid Arthritis: a comparison with Conventional Radiography. Mediterr J Rheumatol 2019; 30:110-113. [PMID: 32185350 PMCID: PMC7045967 DOI: 10.31138/mjr.30.2.110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 03/06/2019] [Accepted: 03/12/2019] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Rheumatoid arthritis (AR) is the most common systemic inflammatory disease of joints, with prevalence of 1% worldwide. Bone erosion (BE) is a central feature of rheumatoid arthritis and is associated with disease severity and poor functional outcome. Conventional Radiography (CR) and Ultrasonography (US) play an important role in the diagnosis of RA. The aim of this study was to compare the value of two methods in the detection of BE in AR patients. METHODS In this cross-sectional study, 111 patients with confirmed RA have been randomly selected and were studied. A checklist which includes demographic information such as age, gender, place of residence, history of smoking, education level and history of rheumatologic disease was completed for all patients, and then radiography and high-resolution US of dominant hands and wrists of metacarpophalangeal (MCP) joint were performed. Collected data was analysed by statistical methods in SPSS version 22. RESULTS The results of this study showed that there is no significant difference between these two methods in detection of BE. In age groups < 44 years old, US with 98% had more sensitivity than CR with 89%. CONCLUSION Results showed that there is no significant difference in diagnostic value of US in bone erosion in patients with rheumatoid arthritis, in comparison with CR in terms of gender and diagnosis for the existence of erosions; however, in determining the amount of BE in age groups < 44 years old, US has better performance than CR.
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Affiliation(s)
- Hasan Anari
- Department of Radiology, Ardabil University of Medical Science, Ardabil, Iran
| | | | - Farhad Pourfarzi
- Department of Community Medicine, Ardabil University of Medical Science, Ardabil, Iran
| | - Negin Ramazani
- Faculty of Medicine, Ardabil University of Medical Science, Ardabil, Iran
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Stok KS, Finzel S, Burghardt AJ, Conaghan PG, Barnabe C. The SPECTRA Collaboration OMERACT Special Interest Group: Current Research and Future Directions. J Rheumatol 2017; 44:1911-1915. [PMID: 28765253 DOI: 10.3899/jrheum.161197] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2017] [Indexed: 01/17/2023]
Abstract
OBJECTIVE High-resolution peripheral quantitative computed tomography (HR-pQCT) has the potential to improve radiographic progression determination in clinical trials and longitudinal observational studies. The goal of this work was to describe the current state of research presented at Outcome Measures in Rheumatology (OMERACT) 2016 and ensuing future directions outlined during discussion among attendees. METHODS At OMERACT 2016, SPECTRA (Study grouP for xtrEme-Computed Tomography in Rheumatoid Arthritis) introduced efforts to (1) validate the HR-pQCT according to OMERACT guidelines, focusing on rheumatoid arthritis (RA), and (2) find alternatives for automated joint space width (JSW) analysis. The Special Interest Group (SIG) was presented to patient research partners, physicians/researchers, and SIG leaders followed by a 40-min discussion on future directions. RESULTS A consensus definition for RA erosion using HR-pQCT was demonstrated through a systematic literature review and a Delphi exercise. Histopathology and perfusion studies were presented that analyzed the true characteristics of cortical breaks in HR-pQCT images, and to provide criterion validity. Results indicate that readers were able to discriminate between erosion and small vascular channels. Moderate reliability (ICC 0.206-0.871) of direct erosion size measures was shown, which improved (> 0.9) only when experienced readers were considered. Quantification of erosion size was presented for scoring, direct measurement, and volumetric approaches, as well as a reliability exercise for direct measurement. Three methods for JSW measurement were compared, all indicating excellent reproducibility with differences at the extremes (i.e., near-zero and joint edge thickness). CONCLUSION Initial reports on HR-pQCT are promising; however, to consider its use in clinical trials and longitudinal observational studies, it is imperative to assess the responsiveness of erosion measurement quantification.
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Affiliation(s)
- Kathryn S Stok
- From the Institute for Biomechanics, ETH Zurich, Zurich, Switzerland; Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia; Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and UK National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds, UK; Departments of Medicine and Community Health Sciences, University of Calgary; McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada. .,K.S. Stok, PhD, Senior Lecturer, Institute for Biomechanics, ETH Zurich, and Department of Biomedical Engineering, University of Melbourne; S. Finzel, MD, Senior Attending Physician, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University of Freiburg; A.J. Burghardt, BS, Research Specialist, Department of Radiology and Biomedical Imaging, University of California; P.G. Conaghan, MD, PhD, Professor, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre; C. Barnabe, MD, MSc, Associate Professor, Departments of Medicine and Community Health Sciences, University of Calgary, and McCaig Institute for Bone and Joint Health, University of Calgary.
| | - Stephanie Finzel
- From the Institute for Biomechanics, ETH Zurich, Zurich, Switzerland; Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia; Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and UK National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds, UK; Departments of Medicine and Community Health Sciences, University of Calgary; McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada.,K.S. Stok, PhD, Senior Lecturer, Institute for Biomechanics, ETH Zurich, and Department of Biomedical Engineering, University of Melbourne; S. Finzel, MD, Senior Attending Physician, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University of Freiburg; A.J. Burghardt, BS, Research Specialist, Department of Radiology and Biomedical Imaging, University of California; P.G. Conaghan, MD, PhD, Professor, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre; C. Barnabe, MD, MSc, Associate Professor, Departments of Medicine and Community Health Sciences, University of Calgary, and McCaig Institute for Bone and Joint Health, University of Calgary
| | - Andrew J Burghardt
- From the Institute for Biomechanics, ETH Zurich, Zurich, Switzerland; Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia; Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and UK National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds, UK; Departments of Medicine and Community Health Sciences, University of Calgary; McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada.,K.S. Stok, PhD, Senior Lecturer, Institute for Biomechanics, ETH Zurich, and Department of Biomedical Engineering, University of Melbourne; S. Finzel, MD, Senior Attending Physician, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University of Freiburg; A.J. Burghardt, BS, Research Specialist, Department of Radiology and Biomedical Imaging, University of California; P.G. Conaghan, MD, PhD, Professor, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre; C. Barnabe, MD, MSc, Associate Professor, Departments of Medicine and Community Health Sciences, University of Calgary, and McCaig Institute for Bone and Joint Health, University of Calgary
| | - Philip G Conaghan
- From the Institute for Biomechanics, ETH Zurich, Zurich, Switzerland; Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia; Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and UK National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds, UK; Departments of Medicine and Community Health Sciences, University of Calgary; McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada.,K.S. Stok, PhD, Senior Lecturer, Institute for Biomechanics, ETH Zurich, and Department of Biomedical Engineering, University of Melbourne; S. Finzel, MD, Senior Attending Physician, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University of Freiburg; A.J. Burghardt, BS, Research Specialist, Department of Radiology and Biomedical Imaging, University of California; P.G. Conaghan, MD, PhD, Professor, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre; C. Barnabe, MD, MSc, Associate Professor, Departments of Medicine and Community Health Sciences, University of Calgary, and McCaig Institute for Bone and Joint Health, University of Calgary
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Paccou J, Edwards M, Moss C, Dennison E, Cooper C. High-resolution imaging of bone and joint architecture in rheumatoid arthritis. Br Med Bull 2014; 112:107-18. [PMID: 25403741 DOI: 10.1093/bmb/ldu033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Rheumatoid arthritis (RA) is characterized by local and systemic bone loss caused by increased bone resorption. We describe the current utilization of high-resolution peripheral quantitative computed tomography (HR-pQCT) in the evaluation of bone and joint in RA. SOURCES OF DATA PubMed was searched for publications using keywords that included 'bone microarchitecture', 'high-resolution peripheral quantitative computed tomography' and 'rheumatoid arthritis'. AREAS OF AGREEMENT HR-pQCT may simultaneously allow assessment of trabecular and cortical bone parameters and be a useful method for depicting bone erosions. AREAS OF CONTROVERSY HR-pQCT only assesses bone microarchitecture at the distal radius and tibia. Controversy exists regarding the optimal way to differentiate cortical and trabecular regions. GROWING POINTS Although HR-pQCT is currently a research tool, there is potential for its use in the clinical diagnosis and management in RA. Further research is required to evaluate the clinical relevance of imaging abnormalities identified in RA patients.
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Affiliation(s)
- Julien Paccou
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Rd, Southampton, Hampshire SO16 6YD, UK
| | - Mark Edwards
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Rd, Southampton, Hampshire SO16 6YD, UK
| | - Charlotte Moss
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Rd, Southampton, Hampshire SO16 6YD, UK
| | - Elaine Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Rd, Southampton, Hampshire SO16 6YD, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Rd, Southampton, Hampshire SO16 6YD, UK
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