Pfeil Alexander, Krojniak Laura, Renz Diane M, Reinhardt Lisa, Franz Marcus, Oelzner Peter, Wolf Gunter, Böttcher Joachim
Department of Internal Medicine III, Jena University Hospital-Friedrich Schiller University Jena, Erlanger Allee 101, Jena, 07747, Germany.
Institute of Diagnostic and Interventional Radiology, Jena University Hospital-Friedrich Schiller University Jena, Erlanger Allee 101, Jena, 07747, Germany.
Arthritis Res Ther. 2016 Oct 25;18(1):248. doi: 10.1186/s13075-016-1145-4.
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.
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-score) 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).
For the total PsA study cohort, the T-score 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.
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.
BoneXpert（BX）是一种新开发的基于数字X线摄影测量法的医疗设备，用于测量人体皮质骨厚度。本研究的目的是量化银屑病关节炎（PsA）患者掌骨的皮质骨丢失情况，并将这些结果与其他放射学评分方法进行比较。
该研究纳入了104例确诊为PsA的患者。采用BX方法测量掌骨（II-IV）的掌骨指数（MCI）。此外，计算MCI的T值。根据Wassenberg等人发表的银屑病关节炎莱茵评分（增殖评分和破坏评分）以及银屑病关节炎改良的van der Heijde Sharp评分（关节间隙狭窄评分和侵蚀评分）确定放射学严重程度。
对于整个PsA研究队列，T值显著降低了-1.289±1.313标准差。MCI与银屑病关节炎莱茵评分的增殖评分（r=-0.732；p<0.001）和破坏评分（r=-0.771；p<0.001）呈负相关。银屑病关节炎改良的van der Heijde Sharp评分的相关性系数较低。在此背景下，通过MCI测量量化了与PsA相关的、依赖于严重程度的关节周围脱矿质情况。在破坏评分中，MCI降低最为显著，为-30.8%（p<0.01）。
BX MCI评分显示PsA患者存在关节周围脱矿质和依赖于严重程度的骨质流失。BX技术的测量能够敏感地区分影响骨完整性的疾病表现的不同阶段，因此似乎有潜力成为PsA放射学进展的替代标志物。
