Platten Michael, Kisten Yogan, Kälvesten Johan, Arnaud Laurent, Forslind Kristina, van Vollenhoven Ronald
Department of Medicine, Unit for Clinical Therapy Research, Inflammatory Diseases (ClinTRID), Karolinska Institute, Stockholm, Sweden.
Medicine and Health Sciences, Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.
RMD Open. 2017 Jun 29;3(1):e000369. doi: 10.1136/rmdopen-2016-000369. eCollection 2017.
To study fully automated digital joint space width (JSW) and bone mineral density (BMD) in relation to a conventional radiographic scoring method in early rheumatoid arthritis (eRA).
Radiographs scored by the modified Sharp van der Heijde score (SHS) in patients with eRA were acquired from the SWEdish FarmacOTherapy study. Fully automated JSW measurements of bilateral metacarpals 2, 3 and 4 were compared with the joint space narrowing (JSN) score in SHS. Multilevel mixed model statistics were applied to calculate the significance of the association between ΔJSW and ΔBMD over 1 year, and the JSW differences between damaged and undamaged joints as evaluated by the JSN.
Based on 576 joints of 96 patients with eRA, a significant reduction from baseline to 1 year was observed in the JSW from 1.69 (±0.19) mm to 1.66 (±0.19) mm (p<0.01), and BMD from 0.583 (±0.068) g/cm to 0.566 (±0.074) g/cm (p<0.01). A significant positive association was observed between ΔJSW and ΔBMD over 1 year (p<0.0001). On an individual joint level, JSWs of undamaged (JSN=0) joints were wider than damaged (JSN>0) joints: 1.68 mm (95% CI 1.70 to 1.67) vs 1.54 mm (95% CI 1.63 to 1.46). Similarly the unadjusted multilevel model showed significant differences in JSW between undamaged (1.68 mm (95% CI 1.72 to 1.64)) and damaged joints (1.63 mm (95% CI 1.68 to 1.58)) (p=0.0048). This difference remained significant in the adjusted model: 1.66 mm (95% CI 1.70 to 1.61) vs 1.62 mm (95% CI 1.68 to 1.56) (p=0.042).
To measure the JSW with this fully automated digital tool may be useful as a quick and observer-independent application for evaluating cartilage damage in eRA.
NCT00764725.
研究早期类风湿关节炎（eRA）中全自动数字关节间隙宽度（JSW）和骨密度（BMD）与传统放射学评分方法之间的关系。
从瑞典药物治疗研究中获取eRA患者经改良Sharp van der Heijde评分（SHS）的X线片。将双侧第2、3和4掌骨的全自动JSW测量值与SHS中的关节间隙变窄（JSN）评分进行比较。应用多水平混合模型统计方法计算1年内ΔJSW与ΔBMD之间关联的显著性，以及经JSN评估的受损和未受损关节之间的JSW差异。
基于96例eRA患者的576个关节，观察到从基线到1年JSW有显著降低，从1.69（±0.19）mm降至1.66（±0.19）mm（p<0.01），BMD从0.583（±0.068）g/cm降至0.566（±0.074）g/cm（p<0.01）。1年内ΔJSW与ΔBMD之间观察到显著正相关（p<0.0001）。在个体关节水平上，未受损（JSN = 0）关节的JSW比受损（JSN>0）关节宽：1.68mm（95%CI 1.70至1.67）对1.54mm（95%CI 1.63至1.46）。同样，未调整的多水平模型显示未受损（1.68mm（95%CI 1.72至1.64））和受损关节（1.63mm（95%CI 1.68至1.58））之间JSW存在显著差异（p = 0.0048）。在调整模型中这种差异仍然显著：1.66mm（95%CI 1.70至1.61）对1.62mm（95%CI 1.68至1.56）（p = 0.042）。
使用这种全自动数字工具测量JSW可能作为一种快速且独立于观察者的应用，用于评估eRA中的软骨损伤。
NCT00764725。
