Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Bone. 2024 Dec;189:117250. doi: 10.1016/j.bone.2024.117250. Epub 2024 Sep 3.
To investigate which joint microarchitectural parameters measured by high-resolution peripheral quantitative computed tomography (HR-pQCT) serve as imaging markers for rheumatoid arthritis (RA).
The second and third metacarpophalangeal (MCP) joints of 50 patients with RA and 50 healthy controls (HCs) (aged 50-79 years, all females) were scanned using a HR-pQCT. Joint space, trabecular bone microarchitecture, and erosion were measured and compared between RA patients and HCs.
There were no differences in joint space parameters between RA patients and HCs. For bone microarchitecture, RA patients had lower trabecular bone mineral density (127 vs. 167 mg/cm), thinner trabecular thickness (0.20 vs. 0.21 mm), fewer trabecular number (1.49 vs. 1.55 /mm), more rod-like structure (1.68 vs. 1.23), and poorer trabecular connectivity (4.51 vs. 5.72 /mm) than HCs. Regarding erosion, RA patients had a higher number of erosions per joint (36/100 vs. 18/100), larger volume (4.62 vs. 1.89 mm), and longer width (2.40 vs. 1.82 mm) and longer length (2.34 vs. 1.64 mm) than HCs. Most of the erosions in HCs were <5 mm in volume (95 %) and located on the radial side (85 %). When erosions <5 mm were compared between RA patients and HCs, there were no differences in their location or morphology.
Deterioration of bone microarchitecture and existences of erosions >5 mm in the MCP joints are sensitive imaging markers of RA. Erosions <5 mm in RA patients may include not only early pathological erosion but also physiological erosion because even HCs can have erosions <5 mm.
探讨高分辨率外周定量 CT（HR-pQCT）测量的哪些关节微观结构参数可作为类风湿关节炎（RA）的影像学标志物。
对 50 例 RA 患者和 50 例健康对照者（年龄 50-79 岁，均为女性）的第二和第三掌指（MCP）关节进行 HR-pQCT 扫描。比较 RA 患者和健康对照者的关节间隙、骨小梁微观结构和侵蚀情况。
RA 患者与健康对照者的关节间隙参数无差异。在骨微观结构方面，RA 患者的骨小梁骨密度较低（127 比 167 mg/cm），骨小梁厚度较薄（0.20 比 0.21 mm），骨小梁数量较少（1.49 比 1.55/mm），杆状结构较多（1.68 比 1.23），骨小梁连通性较差（4.51 比 5.72/mm）。在侵蚀方面，RA 患者的每个关节侵蚀数较多（36/100 比 18/100），侵蚀体积较大（4.62 比 1.89 mm），宽度较长（2.40 比 1.82 mm），长度较长（2.34 比 1.64 mm）。健康对照者的大多数侵蚀体积<5 mm（95%），位于桡侧（85%）。当比较 RA 患者和健康对照者的<5 mm 侵蚀时，其位置或形态无差异。
MCP 关节骨微观结构恶化和>5 mm 的侵蚀存在是 RA 的敏感影像学标志物。RA 患者的<5 mm 侵蚀可能不仅包括早期病理性侵蚀，还包括生理性侵蚀，因为即使是健康对照者也可能有<5 mm 的侵蚀。
