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Çelik DŞ, Ayar K, Ermurat S, Üstündağ Y. Fibroblast growth factor 23 (Fgf23) levels and their relationship with disease activity, bone mineral density, and radiological damage score in patients with rheumatoid arthritis: a single center case–control study. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2022. [DOI: 10.1186/s43166-022-00152-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
There is limited and conflicting information on Fgf23 levels and their relationship with bone loss and disease activity in rheumatoid arthritis (RA). The aim of this study was to compare Fgf23 levels in RA patients with a healthy population and to evaluate the relationship between Fgf23 levels in RA with disease activity, bone mineral density (BMD), and radiological damage score.
Results
The median Fgf23 levels in patients with RA and in hospital staff were 20.06 (11.2–51.0) and 26.40 (12.6–49.5) pg/ml (P < 0.001), respectively. RA patients were divided into active (DAS28 > 3.2) and inactive (DAS28 ≤ 3.2) subgroups. The median Fgf23 levels in active and inactive RA patients were 22.12 (13.90–51.02) and 17.71 (11.20–31.19) pg/ml, respectively (P = 0.001). BMD of RA patients was evaluated with dual-energy X-ray absorptiometry and radiological damage scores were evaluated independently by two investigators using the modified Sharp score (MSS). In RA patients, Fgf23 values correlated with DAS28 and with erosion score of observer-2 (r = 0.297, P = 0.036), but not with erosion score of observer-1 (r = 0.252, P = 0.077). No correlation was found between DAS28 and femur and lumbar vertebra BMD.
Conclusion
In RA, Fgf23 is not associated with BMD but may be associated with local bone loss and disease activity.
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Pfeil A, Oelzner P, Hoffmann T, Renz DM, Wolf G, Böttcher J. Sind röntgenologische Scoring-Methoden als Parameter zur
Verlaufsbeurteilung der rheumatoiden Arthritis noch
zeitgemäß? AKTUEL RHEUMATOL 2021. [DOI: 10.1055/a-1394-0299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
ZusammenfassungDie radiologische Progression beschreibt das Ausmaß der
Gelenkzerstörung im Verlauf einer rheumatoiden Arthritis. Zur
Quantifizierung der radiologischen Progression werden Scoring-Methoden
(z. B. van der Heijde Modifikation des Sharp-Score) eingesetzt. In
verschiedenen Studien zu biologischen- bzw. target-synthetischen Disease
Modifying Anti-Rheumatic Drugs gelang nur unzureichend eine Differenzierung
der radiologischen Progression. Zudem finden die Scores oft keinen
routinemäßigen Einsatz in der klinischen
Entscheidungsfindung. Durch die computerbasierte Analyse von
Handröntgenaufnahmen ist eine valide Quantifizierung der
radiologischen Progression und die zuverlässige Bewertung von
Therapieeffekten möglich. Somit stellen die computerbasierten
Methoden eine vielversprechende Alternative in der Quantifizierung der
radiologischen Progression dar.
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Affiliation(s)
- Alexander Pfeil
- Klinik für Innere Medizin III, Universitätsklinikum
Jena, Jena, Deutschland
| | - Peter Oelzner
- Klinik für Innere Medizin III, Universitätsklinikum
Jena, Jena, Deutschland
| | - Tobias Hoffmann
- Klinik für Innere Medizin III, Universitätsklinikum
Jena, Jena, Deutschland
| | - Diane M. Renz
- Institut für Diagnostische und Interventionelle Radiologie,
Medizinische Hochschule Hannover, Hannover, Deutschland
| | - Gunter Wolf
- Klinik für Innere Medizin III, Universitätsklinikum
Jena, Jena, Deutschland
| | - Joachim Böttcher
- Medizinische Fakultät, Friedrich-Schiller-Universität
Jena, Jena, Deutschland
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Inhibition of periarticular bone loss is associated with clinical remission and ACR70-Response in rheumatoid arthritis. Rheumatol Int 2018; 39:637-645. [PMID: 30569216 DOI: 10.1007/s00296-018-4226-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 12/11/2018] [Indexed: 12/29/2022]
Abstract
The aim of this study, based on a post hoc analysis of the data set used in the RAPID 1 trial, focuses on the associations between metacarpal bone mineral density, as estimated by digital X-ray radiogrammetry (DXR), and clinical remission as well as ACR70-Response in rheumatoid arthritis (RA) patients treated with certolizumab pegol (CZP). The trial evaluates a total of 345 RA patients treated with methotrexate versus CZP 200 mg versus CZP 400 mg. All patients underwent X-rays of the hand at baseline and week 52 as well as computerized calculations of bone mineral density (BMD) by DXR. Clinical remission was defined as DAS28 < 2.6. ACR70-Response was also evaluated. The radiological assessment of disease progression was estimated using the modified total Sharp Score. The mean difference for DAS28 was observed for patients treated with CZP 400 mg (median: - 3.53, minimum: - 6.77; maximum: + 0.48) and CZP 200 mg (median: - 3.13, minimum: - 6.37; maximum: - 0.52) compared to the methotrexate group (median - 2.41, minimum: - 4.76; maximum: + 0.31). The DXR-BMD showed a minor bone loss for the treatment groups undergoing therapy with CZP 200 mg (median: - 0.009 g/cm2, minimum: - 0.059 g/cm2; maximum: + 0.095 g/cm2) and CZP 400 mg (median: - 0.008 g/cm2, minimum: - 0.064 g/cm2; maximum: + 0.080 g/cm2). The methotrexate group presented an advanced periarticular metacarpal bone loss as measured by DXR-BMD (median: - 0.024 g/cm2, minimum: - 0.102 g/cm2; maximum: + 0.057 g/cm2). In the case of clinical remission and ACR70-Response, no significant change of the DXR-BMD was observed for both CZP groups. The study highlights that patients treated with CZP show a less accentuated periarticular bone loss as estimated by DXR in comparison to patients with methotrexate plus placebo. In addition, patients with clinical remission and ACR70-Response revealed no periarticular demineralisation.
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Pfeil A, Haugeberg G, Renz DM, Reinhardt L, Jung C, Franz M, Wolf G, Böttcher J. Digital X-ray radiogrammetry and its sensitivity and specificity for the identification of rheumatoid arthritis-related cortical hand bone loss. J Bone Miner Metab 2017; 35:192-198. [PMID: 26979320 DOI: 10.1007/s00774-016-0741-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 01/22/2016] [Indexed: 01/01/2023]
Abstract
Digital X-ray radiogrammetry (DXR) is a computer-assisted diagnosis technique for quantifying cortical hand bone mineral density (BMD) as well as the metacarpal index (MCI) in the metacarpal bones from radiographs. The objective was to compare DXR-BMD and DXR-MCI between healthy individuals and patients with rheumatoid arthritis (RA) and verify the sensitivity and specificity of this technique for the identification of cortical hand bone loss as an additional diagnostic approach in RA. 618 patients were enrolled and divided into two groups: those with RA (n = 309) and a healthy control group (n = 309) as a reference database. DXR-BMD and the DXR-MCI were measured by DXR using hand radiographs. The severity of RA was evaluated by the modified Larsen score. Mean values for DXR-BMD and DXR-MCI in RA patients were significantly lower compared to healthy subjects (-20.7 and -21.1 %, respectively). Depending on the severity of RA-related joint damage, DXR-BMD revealed a significant reduction of -28.1 % and DXR-MCI -28.2 %, comparing score 1 and score 5 of the modified Larsen score. Both DXR-BMD and DXR-MCI had a high sensitivity (DXR-BMD 91 %, DXR-MCI 87 %) and a moderate specificity (DXR-BMD 47 %, DXR-MCI 49 %) to identify RA-related cortical hand bone loss. The DXR technique seems to be able to quantify RA-related periarticular bone loss as a characteristic feature in the course of RA. Consequently, periarticular osteoporosis seems to function as a reliable diagnostic approach comparable to erosions and joint space narrowing in the diagnosis of RA and as a surrogate marker for the progression of bone loss in RA.
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Affiliation(s)
- Alexander Pfeil
- Department of Internal Medicine III, Jena University Hospital, Friedrich-Schiller-University Jena, Erlanger Allee 101, 07747, Jena, Germany.
| | - Glenn Haugeberg
- Norwegian University of Science and Technology, Trondheim, Norway
| | - Diane M Renz
- Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Friedrich-Schiller-University Jena, Erlanger Allee 101, 07747, Jena, Germany
| | - Lisa Reinhardt
- Department of Internal Medicine III, Jena University Hospital, Friedrich-Schiller-University Jena, Erlanger Allee 101, 07747, Jena, Germany
| | - Christian Jung
- Department of Medicine, Division of Cardiology, Pulmonology and Vascular Medicine, University Hospital Duesseldorf, Moorenstraße 5, 40225, Duesseldorf, Germany
| | - Marcus Franz
- Department of Internal Medicine I, Jena University Hospital, Friedrich-Schiller-University Jena, Erlanger Allee 101, 07747, Jena, Germany
| | - Gunter Wolf
- Department of Internal Medicine III, Jena University Hospital, Friedrich-Schiller-University Jena, Erlanger Allee 101, 07747, Jena, Germany
| | - Joachim Böttcher
- Institute of Diagnostic and Interventional Radiology, SRH Wald-Klinikum Gera, Straße des Friedens 122, 07548, Gera, Germany
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Pfeil A, Thodberg HH, Renz DM, Reinhardt L, Oelzner P, Wolf G, Böttcher J. Metacarpal bone loss in patients with rheumatoid arthritis estimated by a new Digital X-ray Radiogrammetry method - initial results. BMC Musculoskelet Disord 2017; 18:6. [PMID: 28061837 PMCID: PMC5216610 DOI: 10.1186/s12891-016-1348-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 11/21/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The Digital X-ray Radiogrammetry (DXR) method measures the cortical bone thickness in the shafts of the metacarpals and has demonstrated its relevance in the assessment of hand bone loss caused by rheumatoid arthritis (RA). The aim of this study was to validate a novel approach of the DXR method in comparison with the original version considering patients with RA. METHOD The study includes 49 patients with verified RA. The new version is an extension of the BoneXpert method commonly used in pediatrics which has these characteristics: (1) It introduces a new technique to analyze the images which automatically validates the results for most images, and (2) it defines the measurement region relative to the ends of the metacarpals. The BoneXpert method measures the Metacarpal Index (MCI) at the metacarpal bone (II to IV). Additionally, the MCI is quantified by the DXR X-posure System. RESULTS The new version correctly analyzed all 49 images, and 45 were automatically validated. The standard deviation between the MCI results of the two versions was 2.9% of the mean MCI. The average Larsen score was 2.6 with a standard deviation of 1.3. The correlation of MCI to Larsen score was -0.81 in both versions, and there was no significant difference in their ability to detect erosions. CONCLUSION The new DXR version (BoneXpert) validated 92% of the cases automatically, while the same good correlation to RA severity could be presented compared to the old version.
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Affiliation(s)
- Alexander Pfeil
- Department of Internal Medicine III, Jena University Hospital - Friedrich Schiller University Jena, Erlanger Allee 101, 07747, Jena, Germany.
| | | | - Diane M Renz
- Institute of Diagnostic and Interventional Radiology, Jena University Hospital - Friedrich Schiller University Jena, Erlanger Allee 101, 07747, Jena, Germany
| | - Lisa Reinhardt
- Department of Internal Medicine III, Jena University Hospital - Friedrich Schiller University Jena, Erlanger Allee 101, 07747, Jena, Germany
| | - Peter Oelzner
- Department of Internal Medicine III, Jena University Hospital - Friedrich Schiller University Jena, Erlanger Allee 101, 07747, Jena, Germany
| | - Gunter Wolf
- Department of Internal Medicine III, Jena University Hospital - Friedrich Schiller University Jena, Erlanger Allee 101, 07747, Jena, Germany
| | - Joachim Böttcher
- Institute of Diagnostic and Interventional Radiology, SRH Wald-Klinikum Gera, Straße des Friedens 122, 07548, Gera, Germany
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Schenk O, Huo Y, Vincken KL, van de Laar MA, Kuper IHH, Slump KCH, Lafeber FPJG, Bernelot Moens HJ. Validation of automatic joint space width measurements in hand radiographs in rheumatoid arthritis. J Med Imaging (Bellingham) 2016; 3:044502. [PMID: 27921071 DOI: 10.1117/1.jmi.3.4.044502] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 11/01/2016] [Indexed: 11/14/2022] Open
Abstract
Computerized methods promise quick, objective, and sensitive tools to quantify progression of radiological damage in rheumatoid arthritis (RA). Measurement of joint space width (JSW) in finger and wrist joints with these systems performed comparable to the Sharp-van der Heijde score (SHS). A next step toward clinical use, validation of precision and accuracy in hand joints with minimal damage, is described with a close scrutiny of sources of error. A recently developed system to measure metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints was validated in consecutive hand images of RA patients. To assess the impact of image acquisition, measurements on radiographs from a multicenter trial and from a recent prospective cohort in a single hospital were compared. Precision of the system was tested by comparing the joint space in mm in pairs of subsequent images with a short interval without progression of SHS. In case of incorrect measurements, the source of error was analyzed with a review by human experts. Accuracy was assessed by comparison with reported measurements with other systems. In the two series of radiographs, the system could automatically locate and measure 1003/1088 (92.2%) and 1143/1200 (95.3%) individual joints, respectively. In joints with a normal SHS, the average (SD) size of MCP joints was [Formula: see text] and [Formula: see text] in the two series of radiographs, and of PIP joints [Formula: see text] and [Formula: see text]. The difference in JSW between two serial radiographs with an interval of 6 to 12 months and unchanged SHS was [Formula: see text], indicating very good precision. Errors occurred more often in radiographs from the multicenter cohort than in a more recent series from a single hospital. Detailed analysis of the 55/1125 (4.9%) measurements that had a discrepant paired measurement revealed that variation in the process of image acquisition (exposure in 15% and repositioning in 57%) was a more frequent source of error than incorrect delineation by the software (25%). Various steps in the validation of an automated measurement system for JSW of MCP and PIP joints are described. The use of serial radiographs from different sources, with a short interval and limited damage, is helpful to detect sources of error. Image acquisition, in particular repositioning, is a dominant source of error.
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Affiliation(s)
- Olga Schenk
- University of Twente , MIRA Institute for Biomedical Technology and Technical Medicine, Drienerlolaan 5, 7522 NB, Enschede, The Netherlands
| | - Yinghe Huo
- University Medical Center Utrecht, Image Sciences Institute, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands; University Medical Center Utrecht, Department of Rheumatology and Clinical Immunology, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Koen L Vincken
- University Medical Center Utrecht , Image Sciences Institute, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Mart A van de Laar
- Department of Rheumatology , Medisch Spectrum Twente, Koningsplein 1, 7512 KZ, Enschede, The Netherlands
| | - Ina H H Kuper
- Department of Rheumatology , Medisch Spectrum Twente, Koningsplein 1, 7512 KZ, Enschede, The Netherlands
| | - Kees C H Slump
- University of Twente , MIRA Institute for Biomedical Technology and Technical Medicine, Drienerlolaan 5, 7522 NB, Enschede, The Netherlands
| | - Floris P J G Lafeber
- University Medical Center Utrecht , Department of Rheumatology and Clinical Immunology, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Hein J Bernelot Moens
- Department of Rheumatology , Ziekenhuisgroep Twente, Geerdinksweg 141, 7555 DL, Hengelo, The Netherlands
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A reliability study using computer-based analysis of finger joint space narrowing in rheumatoid arthritis patients. Rheumatol Int 2016; 37:189-195. [PMID: 27796519 DOI: 10.1007/s00296-016-3588-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 10/21/2016] [Indexed: 10/20/2022]
Abstract
The joint space difference index (JSDI) is a newly developed radiographic index which can quantitatively assess joint space narrowing progression of rheumatoid arthritis (RA) patients by using an image subtraction method on a computer. The aim of this study was to investigate the reliability of this method by non-experts utilizing RA image evaluation. Four non-experts assessed JSDI for radiographic images of 510 metacarpophalangeal joints from 51 RA patients twice with an interval of more than 2 weeks. Two rheumatologists and one radiologist as well as the four non-experts examined the joints by using the Sharp-van der Heijde Scoring (SHS) method. The radiologist and four non-experts repeated the scoring with an interval of more than 2 weeks. We calculated intra-/inter-observer reliability using the intra-class correlation coefficients (ICC) for JSDI and SHS scoring, respectively. The intra-/inter-observer reliabilities for the computer-based method were almost perfect (inter-observer ICC, 0.966-0.983; intra-observer ICC, 0.954-0.996). Contrary to this, intra-/inter-observer reliability for SHS by experts was moderate to almost perfect (inter-observer ICC, 0.556-0.849; intra-observer ICC, 0.589-0.839). The results suggest that our computer-based method has high reliability to detect finger joint space narrowing progression in RA patients.
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Pfeil A, Krojniak L, Renz DM, Reinhardt L, Franz M, Oelzner P, Wolf G, Böttcher J. Psoriatic arthritis is associated with bone loss of the metacarpals. Arthritis Res Ther 2016; 18:248. [PMID: 27782850 PMCID: PMC5080685 DOI: 10.1186/s13075-016-1145-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 10/03/2016] [Indexed: 12/21/2022] Open
Abstract
Background BoneXpert (BX) is a newly developed medical device based on digital X-ray radiogrammetry to measure human cortical bone thickness. The aim of this study was to quantify cortical bone loss of the metacarpals in patients with psoriatic arthritis (PsA) and compare these findings with other radiological scoring methods. Methods The study includes 104 patients with verified PsA. The BX method was used to measure the Metacarpal Index (MCI) at the metacarpal bones (II–IV). Additionally, the T-score of the MCI (T-scoreMCI) was calculated. Radiographic severity was determined by the Psoriatic Arthritis Ratingen Score (Proliferation Score and Destruction Score) as published by Wassenberg et al. and the Psoriatic Arthritis modified van der Heijde Sharp Score (Joint Space Narrowing Score and Erosion Score). Results For the total PsA study cohort, the T-scoreMCI was significantly reduced by −1.289 ± 1.313 SD. The MCI negatively correlated with the Proliferation Score (r = −0.732; p < 0.001) and the Destruction Score (r = −0.771; p < 0.001) of the Psoriatic Arthritis Ratingen Score. Lower coefficients of correlations were observed for the Psoriatic Arthritis modified van der Heijde Sharp Score. In this context, a severity-dependent and PsA-related periarticular demineralisation as measured by the MCI was quantified. The strongest reduction of −30.8 % (p < 0.01) was observed for the MCI in the Destruction Score. Conclusions The BX MCI score showed periarticular demineralisation and severity-dependent bone loss in patients with PsA. The measurements of the BX technique were able to sensitively differentiate between the different stages of disease manifestation affecting bone integrity and thereby seem to achieve the potential to be a surrogate marker of radiographic progression in PsA.
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Affiliation(s)
- Alexander Pfeil
- Department of Internal Medicine III, Jena University Hospital-Friedrich Schiller University Jena, Erlanger Allee 101, Jena, 07747, Germany.
| | - Laura Krojniak
- Department of Internal Medicine III, Jena University Hospital-Friedrich Schiller University Jena, Erlanger Allee 101, Jena, 07747, Germany
| | - Diane M Renz
- Institute of Diagnostic and Interventional Radiology, Jena University Hospital-Friedrich Schiller University Jena, Erlanger Allee 101, Jena, 07747, Germany
| | - Lisa Reinhardt
- Department of Internal Medicine III, Jena University Hospital-Friedrich Schiller University Jena, Erlanger Allee 101, Jena, 07747, Germany
| | - Marcus Franz
- Department of Internal Medicine I, Jena University Hospital-Friedrich Schiller University Jena, Erlanger Allee 101, Jena, 07747, Germany
| | - Peter Oelzner
- Department of Internal Medicine III, Jena University Hospital-Friedrich Schiller University Jena, Erlanger Allee 101, Jena, 07747, Germany
| | - Gunter Wolf
- Department of Internal Medicine III, Jena University Hospital-Friedrich Schiller University Jena, Erlanger Allee 101, Jena, 07747, Germany
| | - Joachim Böttcher
- Institute of Diagnostic and Interventional Radiology, SRH Wald-Klinikum Gera, Straße des Friedens 122, Gera, 07548, Germany
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Huo Y, Vincken KL, van der Heijde D, De Hair MJH, Lafeber FP, Viergever MA. Automatic Quantification of Radiographic Finger Joint Space Width of Patients With Early Rheumatoid Arthritis. IEEE Trans Biomed Eng 2016; 63:2177-86. [DOI: 10.1109/tbme.2015.2512941] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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10
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Disease Activity and Bone Mineral Density of MCP Joints in Patients with Rheumatoid and Psoriatic Arthritis: Is There a Correlation?-A Study in Patients Treated with Methotrexate and an Anti-TNF α Agent. ISRN RHEUMATOLOGY 2013; 2013:708323. [PMID: 24381766 PMCID: PMC3871921 DOI: 10.1155/2013/708323] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Accepted: 10/30/2013] [Indexed: 01/01/2023]
Abstract
Background. Bone damage in rheumatoid arthritis (RA) and in psoriatic arthritis (PsA) includes an accelerated bone mineral density (BMD) reduction. The objective was to evaluate BMD variations of the metacarpophalangeal joints (MCPs) in patients starting treatment with methotrexate (MTX) or etanercept. Methods. Patients affected by RA or PsA with hand joints involvement and with moderate or high disease activity, were enrolled in this study. All patients underwent clinical examination, laboratory exams, and a DXA scan of the most affected hand, as assessed with an ultrasound examination at the baseline, at the time of enrolment and after 1, 3, 6, and 12 months. Patients non-responders to MTX received combination therapy, while patients with no previous treatment initiated MTX. Results. 22 patients were enrolled. In both RA and PsA groups, BMD increased independently of the treatment. However, in the patients affected by RA, a slight BMD decrease was observed at the last checkup. Globally, the BMD variations of the MCPs were strongly correlated with the disease activity. At the reduction of DAS28, the scores corresponded an increase of BMD. Conclusions. MCPs BMD is inversely correlated to disease activity. BMD increase seems to be correlated with the response to treatment and not with the drug itself.
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Pfeil A, Renz DM, Hansch A, Kainberger F, Lehmann G, Malich A, Wolf G, Böttcher J. The usefulness of computer-aided joint space analysis in the assessment of rheumatoid arthritis. Joint Bone Spine 2012; 80:380-5. [PMID: 23245655 DOI: 10.1016/j.jbspin.2012.10.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Accepted: 10/26/2012] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Computer-aided joint space analysis (CAJSA) is a newly developed technique for the measurement of radiogeometrically detectable joint space widths of the metacarpal-phalangeal (JSD-MCP) and proximal-interphalangeal articulations (JSD-PIP). The aim of this study was to verify the sensitivity and specificity of these CAJSA measurements in the assessment of established RA. METHODS Four hundred and fifty-eight participants (248 healthy subjects, 210 RA patients) underwent computerized semi-automated measurements of the JSD-MCP and JSD-PIP articulations (CAJSA, Radiogrammetry Kit, Version 1.3.6) based on digitally performed radiographs. The Sharp joint space narrowing score was also performed to determine RA-related joint space narrowing. RESULTS The significant severity-dependent reduction for JSD-MCP was -44.0% and for JSD-PIP, -25.94% between Sharp scores 0 and 3. The sensitivity and specificity of JSD-MCP (total) was 88.1% versus 77.8%, respectively (AUC = 0.920; P < 0.001). Furthermore, JSD-PIP (total) revealed a lower sensitivity and specificity with 61.4% and 88.7% (AUC = 0.878; P < 0.001). CONCLUSION The CAJSA method presented a reliable assessment of disease-related joint space narrowing in patients suffering from RA with excellent sensitivity and specificity. By providing quantitative data, other scoring methods could be significantly improved, and thereby the accuracy of the diagnosis and a better therapeutic evaluation could be achieved.
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Affiliation(s)
- Alexander Pfeil
- Department of Internal Medicine III, Jena University Hospital, Friedrich Schiller University Jena, Erlanger Allee 101, 07747 Jena, Germany.
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Pfeil A, Hansch A, Sommerfeld J, Fröber R, Renz DM, Lehmann G, Malich A, Wolf G, Böttcher J. Reproducibility and influence of hand rotation on computer-aided joint space analysis. Joint Bone Spine 2011; 79:384-8. [PMID: 21963809 DOI: 10.1016/j.jbspin.2011.07.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Accepted: 07/25/2011] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Computer-aided joint space analysis (CAJSA) is a recently developed, semi-automated tool to aid in the measurement of joint space margins based on hand radiographs. The objective of this study is to verify the potential effect of hand rotation during X-ray imaging on the measurement of joint space width using CAJSA and to evaluate the reproducibility of the CAJSA technique in healthy subjects and in patients with rheumatoid arthritis. METHODS All joint space distance (JSD) measurements were performed using CAJSA-technology at the metacarpophalangeal articulation based on conventional and digital hand radiographs. RESULTS I. Hand rotation showed an effect on the reproducibility with CV ranging between 0.39% (angulation 1°) and 1.66% (angulation 19°). II. Regarding the overall reproducibility of the CAJSA method, the intra-radiograph reproducibility of JSD was calculated with CV=0.54% for conventional images and CV=0.38% for digital images. The inter-radiograph reproducibility error was observed with CV=0.66% (conventional images) and CV=0.63% (digital images). III. The study revealed a reproducibility for CAJSA measurements in RA ranging between 0.37% (JSD-MCP ring finger; van der Heijde-modification of the Sharp method score 1) to 1.37% (JSD-MCP index finger; van der Heijde-modification of the Sharp method score 3). CONCLUSION CAJSA measures JSD at the metacarpophalangeal articulation with high reproducibility in healthy subjects and in patients with differing stages of rheumatoid arthritis. Additional findings show that hand rotation during X-ray imaging has an impact on the CAJSA measurements; thus avoiding acquisition of hand radiographs with a rotation error of more than 15 degrees can be recommended.
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Pfeil A, Haugeberg G, Hansch A, Renz DM, Lehmann G, Malich A, Wolf G, Böttcher J. Value of digital X-ray radiogrammetry in the assessment of inflammatory bone loss in rheumatoid arthritis. Arthritis Care Res (Hoboken) 2011; 63:666-74. [DOI: 10.1002/acr.20423] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Pye SR, Adams JE, Ward KA, Bunn DK, Symmons DPM, O'Neill TW. Disease activity and severity in early inflammatory arthritis predict hand cortical bone loss. Rheumatology (Oxford) 2010; 49:1943-8. [PMID: 20573690 PMCID: PMC2936948 DOI: 10.1093/rheumatology/keq181] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Objectives. To determine the influence of disease-related variables on hand cortical bone loss in women with early inflammatory arthritis (IA), and whether hand cortical bone mass predicts subsequent joint damage. Method. Adults aged ≥16 years with recent onset of IA were recruited to the Norfolk Arthritis Register between 1990 and 1998, and followed prospectively. At baseline, patients had their joints examined for swelling and tenderness and had CRP and disease activity 28-joint assessment score (DAS-28) measured. Radiographs of the hands were performed in a subgroup of patients at Year 1 and at follow-up, which were assessed using digital X-ray radiogrammetry (DXR). They were also evaluated for the presence of erosions using Larsen’s method. Linear mixed models were used to investigate whether disease-related factors predicted change in DXR–areal bone mineral density (BMDa). We also evaluated whether DXR–BMDa predicted the subsequent occurrence of erosive disease. Results. Two hundred and four women, mean (s.d.) age 55.1 (14.0) years, were included. Median follow-up between radiographs was 4 years. The mean within-subject change in BMDa was 0.024 g/cm2 equivalent to 1% decline per year. After adjustment for age, height and weight, compared with those within the lower tertile for CRP, those in the upper tertile had greater subsequent loss of bone. This was true also for DAS-28 and Larsen score. Among those without erosions on the initial radiograph (121), DXR–BMDa at baseline did not predict the new occurrence of erosions. Conclusion. Increased disease activity and severity are associated with accelerated bone loss. However, lower BMDa did not predict the new occurrence of erosive disease.
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Affiliation(s)
- Stephen R Pye
- Arthritis Research UK Epidemiology Unit, The University of Manchester, Manchester M13 9PT, UK
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Güler-Yüksel M, Klarenbeek NB, Goekoop-Ruiterman YPM, de Vries-Bouwstra JK, van der Kooij SM, Gerards AH, Ronday HK, Huizinga TWJ, Dijkmans BAC, Allaart CF, Lems WF. Accelerated hand bone mineral density loss is associated with progressive joint damage in hands and feet in recent-onset rheumatoid arthritis. Arthritis Res Ther 2010; 12:R96. [PMID: 20482894 PMCID: PMC2911882 DOI: 10.1186/ar3025] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2009] [Revised: 03/16/2010] [Accepted: 05/20/2010] [Indexed: 03/20/2023] Open
Abstract
INTRODUCTION To investigate whether accelerated hand bone mineral density (BMD) loss is associated with progressive joint damage in hands and feet in the first year of rheumatoid arthritis (RA) and whether it is an independent predictor of subsequent progressive total joint damage after 4 years. METHODS In 256 recent-onset RA patients, baseline and 1-year hand BMD was measured in metacarpals 2-4 by digital X-ray radiogrammetry. Joint damage in hands and feet were scored in random order according to the Sharp-van der Heijde method at baseline and yearly up to 4 years. RESULTS 68% of the patients had accelerated hand BMD loss (>-0.003 g/cm2) in the first year of RA. Hand BMD loss was associated with progressive joint damage after 1 year both in hands and feet with odds ratios (OR) (95% confidence intervals [CI]) of 5.3 (1.3-20.9) and 3.1 (1.0-9.7). In univariate analysis, hand BMD loss in the first year was a predictor of subsequent progressive total joint damage after 4 years with an OR (95% CI) of 3.1 (1.3-7.6). Multivariate analysis showed that only progressive joint damage in the first year and anti-citrullinated protein antibody positivity were independent predictors of long-term progressive joint damage. CONCLUSIONS In the first year of RA, accelerated hand BMD loss is associated with progressive joint damage in both hands and feet. Hand BMD loss in the first year of recent-onset RA predicts subsequent progressive total joint damage, however not independent of progressive joint damage in the first year.
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Affiliation(s)
- Melek Güler-Yüksel
- Department of Rheumatology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
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Hoff M, Haugeberg G. Using hand bone mass measurements to assess progression of rheumatoid arthritis. Ther Adv Musculoskelet Dis 2010; 2:79-87. [PMID: 22870439 PMCID: PMC3383477 DOI: 10.1177/1759720x10362297] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
In rheumatoid arthritis (RA) bone involvement presents as joint erosions in addition to generalized and periarticular osteoporosis. Joint erosions on radiographs of the hands and feet are considered to be the gold standard to evaluate progression of bone and joint damage in RA, even though erosions on radiographs are not used as a marker of early bone involvement. Periarticular bone loss seen on radiographs may be the first sign of bone involvement in RA. Over the last decade there has been an increased awareness of the importance of early aggressive treatment in RA, leading to a need for methods which can identify bone involvement in the early stages of RA. As inflammatory bone loss, especially at the hand, has been shown to occur early in RA, quantitative measures of hand bone loss have been proposed as an outcome measure for the detection of bone involvement. In this review article we present data supporting the hypothesis that both erosions and osteoporosis in RA occur as a result of the same pathophysiological mechanisms activating the osteoclast. Furthermore the role of hand bone loss as an early marker of inflammatory bone involvement, a predictor of subsequent radiographic joint damage and a response variable to anti-inflammatory treatment is discussed.
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Affiliation(s)
- Mari Hoff
- Department of Rheumatology, St Olavs Hospital, University Hospital of Trondheim, Norway and Norwegian University of Science and Technology, Trondheim, Norway
| | - Glenn Haugeberg
- Department of Rheumatology, St Olavs Hospital, University Hospital of Trondheim, Norway and Norwegian University of Science and Technology, Trondheim, Norway
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Denosumab prevents metacarpal shaft cortical bone loss in patients with erosive rheumatoid arthritis. Arthritis Care Res (Hoboken) 2010; 62:537-44. [DOI: 10.1002/acr.20172] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Peloschek P, Boesen M, Donner R, Kubassova O, Birngruber E, Patsch J, Mayerhöfer M, Langs G. Assessement of rheumatic diseases with computational radiology: current status and future potential. Eur J Radiol 2009; 71:211-6. [PMID: 19457632 DOI: 10.1016/j.ejrad.2009.04.046] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2009] [Accepted: 04/16/2009] [Indexed: 01/08/2023]
Abstract
In recent years, several computational image analysis methods to assess disease progression in rheumatic diseases were presented. This review article explains the basics of these methods as well as their potential application in rheumatic disease monitoring, it covers radiography, sonography as well as magnetic resonance imaging in quantitative analysis frameworks.
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Affiliation(s)
- Philipp Peloschek
- Computational Imaging and Radiology Lab-CIR, Department of Radiology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
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PFEIL ALEXANDER, SCHÄFER MAXL, LEHMANN GABRIELE, SEIDL BETTINAE, EIDNER THORSTEN, MALICH ANSGAR, RENZ DIANEM, OELZNER PETER, HANSCH ANDREAS, WOLF GUNTER, HEIN GERT, KAISER WERNERA, BÖTTCHER JOACHIM. Implementation of Z-Scores as an Age- and Sex-independent Parameter for Estimating Joint Space Widths in Rheumatoid Arthritis. J Rheumatol 2009; 36:717-23. [DOI: 10.3899/jrheum.080651] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Objective.To compare normative data of joint space distances (JSD) with the JSD of patients with rheumatoid arthritis (RA) as measured by computer-aided joint space analysis (CAJSA) at the metacarpophalangeal (MCP) articulations, and to differentiate age- and sex-related alterations from the disease-related joint space narrowing.Methods.In total, 256 healthy subjects and 248 patients with verified RA (following revised ACR criteria) underwent computerized semiautomated measurements of JSD (CAJSA, version 1.3.6) at the MCP articulation (JSD-MCP) based on digital radiographs. The Z-score, a comparative parameter that differentiates joint space alterations caused by RA-related cartilage destruction from age- and sex-related changes, was calculated.Results.Our data showed a relationship between measured joint space widths (MCP total and MCP thumb to little finger) and age for healthy subjects and also the RA group. The RA group revealed an age-related joint space narrowing that was surpassed by the RA-related narrowing of joint space widths classified by Sharp joint space narrowing score and resulting in smaller Z-scores for RA patients.Conclusion.The CAJSA technique seems to distinguish age-related JSD changes in healthy volunteers from RA-induced alterations. In addition the Z-score was also able to differentiate RA-dependent narrowing of JSD. Calculation of the Z-scores based on sex- and age-specific reference data may facilitate earlier identification of patients with RA, allowing initiation of a more optimal, individually adapted therapeutic strategy.
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Kubassova O, Boesen M, Peloschek P, Langs G, Cimmino MA, Bliddal H, Torp-Pedersen S. Quantifying Disease Activity and Damage by Imaging in Rheumatoid Arthritis and Osteoarthritis. Ann N Y Acad Sci 2009; 1154:207-38. [DOI: 10.1111/j.1749-6632.2009.04392.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pfeil A, Hansch A, Lehmann G, Eidner T, Schäfer ML, Oelzner P, Renz DM, Wolf G, Hein G, Kaiser WA, Böttcher J. Impact of sex, age, body mass index and handedness on finger joint space width in patients with prolonged rheumatoid arthritis using computer-aided joint space analysis. Rheumatol Int 2008; 29:517-24. [DOI: 10.1007/s00296-008-0728-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2008] [Accepted: 09/12/2008] [Indexed: 11/24/2022]
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Pfeil A, Böttcher J, Schäfer ML, Seidl BE, Schmidt M, Petrovitch A, Heyne JP, Lehmann G, Oelzner P, Hein G, Wolf G, Kaiser WA. Normative reference values of joint space width estimated by computer-aided joint space analysis (CAJSA): the distal interphalangeal joint. J Digit Imaging 2008; 21 Suppl 1:104-12. [PMID: 17384977 PMCID: PMC3043877 DOI: 10.1007/s10278-007-9031-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2007] [Revised: 01/30/2007] [Accepted: 02/21/2007] [Indexed: 10/23/2022] Open
Abstract
PURPOSE The study introduces reference data for a computer-aided analysis. The semiautomated computer-aided diagnostic system provides the estimation of joint space width at the distal interphalangeal joints, considering gender-specific and age-related changes. PATIENTS AND METHODS 869 subjects (351 female/518 male) with hand x-rays were included and underwent measurements of joint space distances at the distal interphalangeal articulation (JSD-DIP) of the second to the fifth finger using computer-aided joint space analysis (CAJSA). RESULTS Data showed a notable age-related decrease of CAJSA parameters, and an accentuated age-related joint space narrowing in women. Males showed a significantly wider JSD-DIP (+ 16.7%) compared to the female cohort for all age groups. Both men and women revealed an accentuated decrease of JSD-DIP (total) in the age group from 10 to 15 years (for men -10.5% and for women -17.6%). After the age of 21 years a continuous decline of the JSD-DIP (total) is observed. CONCLUSION Our data present gender-specific and age-related normative reference data for computer-aided joint space analysis, which provide a valid and reliable differentiation between disease-related joint space narrowing and age-related joint space narrowing, particularly in patients with osteoarthritis of the fingers.
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Affiliation(s)
- Alexander Pfeil
- Institute of Diagnostic and Interventional Radiology, Friedrich-Schiller-University Jena, Jena, Germany.
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Pfeil A, Lippold J, Eidner T, Lehmann G, Oelzner P, Renz DM, Hansch A, Wolf G, Hein G, Kaiser WA, Böttcher J. Effects of leflunomide and methotrexate in rheumatoid arthritis detected by digital X-ray radiogrammetry and computer-aided joint space analysis. Rheumatol Int 2008; 29:287-95. [DOI: 10.1007/s00296-008-0682-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2008] [Accepted: 08/03/2008] [Indexed: 01/01/2023]
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van 't Klooster R, Hendriks EA, Watt I, Kloppenburg M, Reiber JHC, Stoel BC. Automatic quantification of osteoarthritis in hand radiographs: validation of a new method to measure joint space width. Osteoarthritis Cartilage 2008; 16:18-25. [PMID: 17631389 DOI: 10.1016/j.joca.2007.05.015] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2007] [Accepted: 05/26/2007] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To quantify osteoarthritis (OA) by automatic measurement of the joint space width (JSW) in the finger joints in hand radiographs, and validate this against semi-quantitative scoring. METHODS Forty subjects with primary OA at multiple sites were selected, 20 of which had no joint space narrowing (JSN) in the hand, and 20 had moderate to severe JSN. Conventional hand radiographs were acquired and the image set was split into a training and test set, for developing and evaluating the method, respectively. No methods to quantify the JSW automatically in OA exist; therefore a method was developed. First the semi-automatic image analysis program identifies the metacarpal and interphalangeal joints. Subsequently, the corresponding joint margins and measurement interval are determined. Finally the JSW is measured in millimetres as the average distance between the joint margins enclosed by the measurement interval. The success rates of different steps of the image analysis were evaluated and a comparison was made between the JSW and the semi-quantitative Osteoarthritis Research Society International score for JSN. RESULTS The success rates for the identification of the joint locations and margins were 97.5% and 64.2%, respectively. The JSW decreased with increasing semi-quantitative scores, but increased as the joint was severely damaged. The agreement between the JSW and the semi-quantitative score was confirmed by a significant correlation (R2=0.54 and P<0.01) while assessing hand pairs instead of individual joints. CONCLUSION The JSW measurement closely reflects semi-quantitative scoring of JSN. Therefore, this method is expected to offer a reproducible and accurate measurement of the JSW in OA.
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Affiliation(s)
- R van 't Klooster
- Department of Radiology, Division of Image Processing, Leiden University Medical Center, Leiden, The Netherlands
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Pfeil A, Böttcher J, Seidl BE, Heyne JP, Petrovitch A, Eidner T, Mentzel HJ, Wolf G, Hein G, Kaiser WA. Computer-aided joint space analysis of the metacarpal-phalangeal and proximal-interphalangeal finger joint: normative age-related and gender-specific data. Skeletal Radiol 2007; 36:853-64. [PMID: 17508211 DOI: 10.1007/s00256-007-0304-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2006] [Revised: 02/06/2007] [Accepted: 02/28/2007] [Indexed: 02/02/2023]
Abstract
PURPOSE The purpose of the study was to provide reference data for computer-aided joint space analysis based on a semi-automated and computer-aided diagnostic system for the measurement of metacarpal-phalangeal and proximal-interphalangeal finger joint widths; additionally, the determination of sex differences and the investigation of changes in joint width with age were evaluated. PATIENTS AND METHODS Eighty hundred and sixty-nine patients (351 female and 518 male) received radiographs of the hand for trauma and were screened for a host of conditions known to affect the joint spaces. All participants underwent measurements of joint space distances at the metacarpal-phalangeal articulation (JSD-MCP) from the thumb to the small finger and at the proximal-interphalangeal articulation (JSD-PIP) from the index finger to the small finger using computer-aided diagnosis technology with semi-automated edge detection. RESULTS The study revealed an annual narrowing of the JSD of 0.6% for the JSD-MCP and for the JSD-PIP. Furthermore, the data demonstrated a notable age-related decrease in JSD, including an accentuated age-related joint space narrowing in women for both articulations. Additionally, males showed a significantly wider JSD-MCP (+11.1%) and JSD-PIP (+15.4%) compared with the female cohort in all age groups. CONCLUSION Our data presented gender-specific and age-related normative reference values for computer-aided joint space analysis of the JSD-MCP and JSD-PIP that could be used to identify disease-related joint space narrowing, particularly in patients with osteoarthritis and rheumatoid arthritis commonly involving the peripheral small hand joints.
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Affiliation(s)
- Alexander Pfeil
- Institute of Diagnostic and Interventional Radiology, Friedrich-Schiller-University Jena, Erlanger Allee 101, 07747 Jena, Germany.
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Pfeil A, Böttcher J, Seidl BE, Schäfer ML, Hansch A, Heyne JP, Petrovitch A, Mentzel HJ, Eidner T, Wolf G, Hein G, Kaiser WA. Computer-aided joint space analysis (CAJSA) of the proximal-interphalangeal joint-normative age-related and gender specific data. Acad Radiol 2007; 14:594-602. [PMID: 17434073 DOI: 10.1016/j.acra.2007.01.032] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2006] [Revised: 01/29/2007] [Accepted: 01/29/2007] [Indexed: 01/01/2023]
Abstract
RATIONALE AND OBJECTIVES To provide reference data for computer-aided joint space analysis (CAJSA) based on a semiautomated and computer-aided diagnostic system for the measurement of joint space widths (ie, proximal-interphalangeal joint), considering gender-specific and age-related differences. MATERIALS AND METHODS A total of 869 subjects were enrolled (351 females/518 males) with radiographs of the hand. All participants underwent measurements of joint space distances at the proximal-interphalangeal articulation (JSD-PIP) of the second to fifth finger using CAJSA technology. RESULTS The data verify a notable age-related decrease of CAJSA parameters, showing an accentuated age-related joint space narrowing in women. Additionally, males showed a significant wider JSD-PIP (+15.4%) compared with the female cohort for all age groups. CONCLUSIONS Our data present gender-specific and age-related normative reference values for computer-aided joint space analysis of JSD-PIP and provide a valid and reliable quantification of disease-related joint space narrowing, particularly in patients with osteoarthritis and rheumatoid arthritis involving the peripheral small hand joints.
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Affiliation(s)
- Alexander Pfeil
- Institute of Diagnostic and Interventional Radiology, Friedrich-Schiller-University Jena, Erlanger Allee 101, 07747 Jena, Germany.
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