Abstract:The objective of this cross-sectional study was to define normal sex- and age-dependent values of intra-articular bone mass and microstructures in the metacarpal heads of healthy individuals by high-resolution peripheral quantitative computed tomography (HR-pQCT) and test the effect of rheumatoid arthritis (RA) on these parameters. Human cadaveric metacarpal heads were used to exactly define intra-articular bone. Healthy individuals of different sex and age categories and RA patients with similar age and sex d… Show more
“…Healthy controls and patients with PsA were part of the Erlangen Imaging Cohort (ERIC), which prospectively assesses articular bone composition in healthy controls and patients with arthritis [17]. Three groups were analysed in a cross-sectional setting: (1) patients with PsA, (2) patients with PSO and (3) healthy controls.…”
Section: Methodsmentioning
confidence: 99%
“…Enthesiophytes were identified as bony proliferations at specific anatomical sites (outside or along the insertion of the capsule). Based on previous studies we have exactly defined these anatomical sites by regions of interest (ROIs) [15–17]. If an erosion or enthesiophyte was found in one (axial) plane, the lesion had to be confirmed in the perpendicular plane (coronal or sagittal).Fig.…”
BackgroundComprehensive simultaneous quantification of bone erosion and enthesiophytes in the joints of patients with psoriatic arthritis (PsA) has not been performed. Herein, we aimed to compare the extent of bone erosion and enthesiophytes in patients with PsA, psoriasis (PSO) and healthy controls, assess the influence of age and disease duration on the development of erosions and enthesiophytes and define their impact on physical function.MethodsPatients with PsA or with PSO and controls were analysed by high-resolution peripheral quantitative computed tomography (HR-pQCT). The extent of bone erosions and enthesiophytes was assessed and plotted according to different categories of age, duration of PSO and duration of PsA, respectively. In addition, demographic and disease-specific data, including physical function (health assessment questionnaire) were collected.ResultsA total of 203 patients were analysed; 101 had PsA, 55 had PSO and 47 were healthy individuals. Patients with PsA had significantly more and larger erosions (p = 0.002/p = 0.003) and enthesiophytes (p < 0.001) compared to patients with PSO and healthy controls. Patients with PSO and healthy controls did not differ in erosions, while enthesiophytes were more frequent in patients with PSO than in healthy controls. Bone erosions, but not enthesiophytes, showed strong age-dependency in all three groups. In contrast, enthesiophytes were mostly influenced by the duration of PSO and PsA and, in contrast to bone erosions, were associated with poorer physical function.ConclusionsBone erosions are age-dependent, enhanced in PsA and increase with disease duration. Enthesiophytes are less age-dependent, are enhanced in both PSO and PsA and strongly influenced by disease duration. Enthesiophytes impact physical function in PsA suggesting the need for early therapeutic interventions to prevent damage.
“…Healthy controls and patients with PsA were part of the Erlangen Imaging Cohort (ERIC), which prospectively assesses articular bone composition in healthy controls and patients with arthritis [17]. Three groups were analysed in a cross-sectional setting: (1) patients with PsA, (2) patients with PSO and (3) healthy controls.…”
Section: Methodsmentioning
confidence: 99%
“…Enthesiophytes were identified as bony proliferations at specific anatomical sites (outside or along the insertion of the capsule). Based on previous studies we have exactly defined these anatomical sites by regions of interest (ROIs) [15–17]. If an erosion or enthesiophyte was found in one (axial) plane, the lesion had to be confirmed in the perpendicular plane (coronal or sagittal).Fig.…”
BackgroundComprehensive simultaneous quantification of bone erosion and enthesiophytes in the joints of patients with psoriatic arthritis (PsA) has not been performed. Herein, we aimed to compare the extent of bone erosion and enthesiophytes in patients with PsA, psoriasis (PSO) and healthy controls, assess the influence of age and disease duration on the development of erosions and enthesiophytes and define their impact on physical function.MethodsPatients with PsA or with PSO and controls were analysed by high-resolution peripheral quantitative computed tomography (HR-pQCT). The extent of bone erosions and enthesiophytes was assessed and plotted according to different categories of age, duration of PSO and duration of PsA, respectively. In addition, demographic and disease-specific data, including physical function (health assessment questionnaire) were collected.ResultsA total of 203 patients were analysed; 101 had PsA, 55 had PSO and 47 were healthy individuals. Patients with PsA had significantly more and larger erosions (p = 0.002/p = 0.003) and enthesiophytes (p < 0.001) compared to patients with PSO and healthy controls. Patients with PSO and healthy controls did not differ in erosions, while enthesiophytes were more frequent in patients with PSO than in healthy controls. Bone erosions, but not enthesiophytes, showed strong age-dependency in all three groups. In contrast, enthesiophytes were mostly influenced by the duration of PSO and PsA and, in contrast to bone erosions, were associated with poorer physical function.ConclusionsBone erosions are age-dependent, enhanced in PsA and increase with disease duration. Enthesiophytes are less age-dependent, are enhanced in both PSO and PsA and strongly influenced by disease duration. Enthesiophytes impact physical function in PsA suggesting the need for early therapeutic interventions to prevent damage.
“…Patients with AS were not included in this study because we were specifically seeking to study a population with early bone changes. Recruitment of healthy control subjects has been described elsewhere, and these individuals were matched by age and sex [25]. Briefly, exclusion criteria for being a healthy control subject were (1) presence or history of chronic joint pain/swelling, (2) presence of systemic diseases, (3) documented osteopenia/osteoporosis, (4) present or past use of bisphosphonates or prednisolone, and (5) positivity for anticitrullinated protein antibodies (ACPA) or rheumatoid factor.…”
BackgroundIn the present study, we investigated bone geometry, microstructure, and volumetric bone mineral density (vBMD) in a cohort of patients with nonradiographic axial spondyloarthritis (nr-axSpA) in order to define the early bone changes occurring in axial spondyloarthritis (axSpA) and to define potential factors for deterioration of bone microstructure.MethodsPatients with axSpA (n = 107) and healthy control subjects (n = 50) of similar age and sex were assessed for geometric, volumetric, and microstructural parameters of bone using high-resolution peripheral quantitative computed tomography (HR-pQCT) at the radius. Additionally, demographic and disease-specific characteristics of patients with axSpA were recorded.ResultsPatients with nr-axSpA and control subjects were comparable in age, sex, and body mass index. Geometric and microstructural analysis by HR-pQCT revealed a significantly reduced cortical area (p = 0.022) and cortical thickness (p = 0.006) in patients with nr-axSpA compared with control subjects. Total and cortical vBMD were significantly reduced in patients with nr-axSpA (p = 0.042 and p = 0.007, respectively), whereas there was no difference in trabecular vBMD. Patients with a short disease duration (< 2 years; n = 46) also showed significant reduction of cortical thickness and cortical area compared with control subjects. Patients with disease duration > 2 years (n = 55) additionally developed a decrease of cortical and total vBMD. Multiple regression models identified male sex to be associated with lower cortical vBMD and female sex to be associated with lower trabecular vBMD.ConclusionsBone microstructure in patients with nr-axSpA is characterized primarily by deterioration of cortical bone. Cortical bone loss starts early and is evident within the first 2 years of the disease.Electronic supplementary materialThe online version of this article (10.1186/s13075-018-1620-1) contains supplementary material, which is available to authorized users.
“…Besides the detection of more and larger cortical interruptions in RA, an impaired vBMD and microstructure can be found in the finger joints of patients with RA versus healthy subjects . These parameters at the MCP joints are strongly correlated with the parameters at the distal radius, which are impaired in patients with osteoporosis …”
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