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Title: Heterogeneity of Cortical Breaks in Hand Joints of Patients with Rheumatoid Arthritis and Healthy Controls Imaged by High-resolution Peripheral Quantitative Computed Tomography
Authors: Scharmga, Andrea
Peters, Michiel
van Tubergen, Astrid
van den Bergh, Joop 
Barnabe, Cheryl
Finzel, Stephanie
van Rietbergen, Bert
Geusens, Piet 
Issue Date: 2016
Source: JOURNAL OF RHEUMATOLOGY, 43(10), p. 1914-1920
Abstract: Objective. Conventional radiographs (CR) of the hands are the gold standard for imaging bone erosions. The presence of bone erosions, reflected by the presence of cortical breaks, is a poor prognostic factor in patients with rheumatoid arthritis (RA). The availability of high-resolution peripheral quantitative computed tomography (HR-pQCT) enables detailed investigation of cortical breaks in rheumatic diseases. The aim of this image review is to show HR-pQCT images of the spectrum of cortical breaks with and without underlying trabecular bone changes in metacarpophalangeal (MCP) joints of healthy controls (HC) and patients with RA, with corresponding images on CR and magnetic resonance imaging (MRI). Methods. Second and third MCP joints of 41 patients (of which 10 were early RA with <= 2 years and 24 longstanding RA with >= 10 years of disease duration) and 38 HC were imaged by CR, MRI, and HR-pQCT (XtremeCT1, Scanco Medical AG). Representative images of the spectrum of cortical breaks were selected. Results. Cortical breaks were found in early and longstanding RA, but also in HC. They were heterogeneous in size, location, and number per joint, with a variety of surrounding cortical and underlying trabecular bone characteristics. Conclusion. Using HR-pQCT images of MCP joints, heterogeneous cortical breaks with and without surrounding trabecular bone changes were found, not only in RA but also in HC. The underlying mechanisms and significance of this spectrum of cortical breaks as found with high 3-D resolution needs further investigation.
Notes: [van Tubergen, Astrid] MUMC, Div Rheumatol, Dept Med, POB 5800, NL-6202 AZ Maastricht, Netherlands. CAPHRI, Sch Publ Hlth & Primary Care, Maastricht, Netherlands. NUTRIM, Sch Nutr & Translat Res Metab, Maastricht, Netherlands. Viecuri Med Ctr, Dept Internal Med, Venlo, Netherlands. [van den Bergh, Joop; Geusens, Piet] Hasselt Univ, Fac Med & Life Sci, Hasselt, Belgium. [Barnabe, Cheryl] Univ Calgary, Med & Community Hlth Sci, Calgary, AB, Canada. [Finzel, Stephanie] Univ Freiburg, Dept Rheumatol & Clin Immunol, Univ Med Ctr Freiburg, Fac Med, Freiburg, Germany. [van Rietbergen, Bert] Eindhoven Univ Technol, Fac Biomed Engn, Eindhoven, Netherlands. [Scharmga, Andrea; Peters, Michiel] MUMC, CAPHRI, Dept Med, Div Rheumatol, Maastricht, Netherlands. [Scharmga, Andrea; Peters, Michiel] NUTRIM, Maastricht, Netherlands. [van Tubergen, Astrid; Geusens, Piet] CAPHRI, Maastricht, Netherlands. [van den Bergh, Joop] Viecuri Med Ctr, NUTRIM, Dept Internal Med, Venlo, Netherlands.
Keywords: rheumatoid arthriti; bon; computed tomography;RHEUMATOID ARTHRITIS; BONE; COMPUTED TOMOGRAPHY
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ISSN: 0315-162X
e-ISSN: 1499-2752
DOI: 10.3899/jrheum.160646
ISI #: 000390233000022
Category: A1
Type: Journal Contribution
Validations: ecoom 2018
Appears in Collections:Research publications

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