Böttcher J, Pfeil A, Rosholm A, Petrovitch A, Seidl B E, Malich A, Schäfer M L, Kramer A, Mentzel H J, Lehmann G, Hein G, Kaiser W A
Friedrich Schiller University Jena, Jena, Germany.
Arthritis Rheum. 2005 Dec;52(12):3850-9. doi: 10.1002/art.21606.
To evaluate digital x-ray radiogrammetry (DXR) and the Radiogrammetry Kit program as new diagnostic tools for quantifying disease-related periarticular osteoporosis and for measuring joint space narrowing according to the severity and duration of rheumatoid arthritis (RA).
Using DXR, we performed computerized calculations of bone mineral density (BMD) and the metacarpal index (MCI) in 258 patients with active RA. Using the Radiogrammetry Kit program, we also performed semiautomated measurements of joint space width (JSW) at the second through the fifth metacarpophalangeal (MCP) joints in these patients.
All correlations between the different parameters of both techniques (BMD and the MCI as measured by DXR and MCP JSW as measured by the Radiogrammetry Kit) were significant (0.36 < or = R < or = 0.63; P < 0.01). As expected, a significant negative association was shown between the different MCP JSW results and the results of all scoring methods (-0.67 < or = R < or = -0.29). The BMD and the MCI measured by DXR both decreased significantly between Steinbrocker stage I and stage IV (by 32.7% and 36.6%, respectively; both P < 0.01). Reductions in the overall (mean) MCP JSW varied from 35.3% (Larsen score) to 52.9% (Steinbrocker stage). Over a period of 6 years, we observed relative decreases in BMD and the MCI as measured by DXR (32.1% and 33.3%, respectively), as well as in the overall (mean) MCP JSW (23.5%), and these were pronounced in early RA (duration <1 year). In addition, excellent reproducibility of DXR and Radiogrammetry Kit parameters was verified (coefficients of variation <1%).
DXR with the integrated Radiogrammetry Kit program could be a promising, widely available diagnostic tool for supplementing the different RA scoring methods with quantitative data, thus allowing an earlier and improved diagnosis of RA and more precision in determining disease progression.
评估数字X线摄影测量法（DXR）和摄影测量套件程序，作为量化疾病相关关节周围骨质疏松以及根据类风湿关节炎（RA）的严重程度和病程测量关节间隙变窄的新型诊断工具。
我们使用DXR对258例活动期RA患者进行了骨密度（BMD）和掌骨指数（MCI）的计算机化计算。我们还使用摄影测量套件程序对这些患者第二至第五掌指（MCP）关节的关节间隙宽度（JSW）进行了半自动测量。
两种技术的不同参数之间的所有相关性（DXR测量的BMD和MCI以及摄影测量套件测量的MCP JSW）均具有显著性（0.36≤R≤0.63；P<0.01）。正如预期的那样，不同的MCP JSW结果与所有评分方法的结果之间显示出显著的负相关（-0.67≤R≤-0.29）。在Steinbrocker I期和IV期之间，DXR测量的BMD和MCI均显著降低（分别降低32.7%和36.6%；P均<0.01）。MCP JSW总体（平均）降低幅度从35.3%（Larsen评分）到52.9%（Steinbrocker分期）不等。在6年的时间里，我们观察到DXR测量的BMD和MCI相对降低（分别为32.1%和33.3%），以及MCP JSW总体（平均）降低（23.5%），且这些在早期RA（病程<1年）中更为明显。此外，还验证了DXR和摄影测量套件参数具有出色的可重复性（变异系数<1%）。
结合摄影测量套件程序的DXR可能是一种有前景的、广泛可用的诊断工具，可为不同的RA评分方法补充定量数据，从而实现RA的早期和更好诊断，并在确定疾病进展方面更精确。
