Decreased Quantity and Quality of the Periarticular and Nonperiarticular Bone in Patients With Rheumatoid Arthritis: A Cross-Sectional HR-pQCT Study

Kocijan, Roland; Finzel, Stephanie; Englbrecht, Matthias; Engelke, Klaus; Rech, Jürgen; Schett, Georg

doi:10.1002/jbmr.2109

Cited by 55 publications

(47 citation statements)

References 49 publications

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“…Overall, microstructural differences between male RA patients and controls are similar to those found in female RA patients as reported in our previous study and in a recent HR‐pQCT–based study by Kocijan and colleagues, and, also similar to female RA patients, they were not influenced by body weight or sex hormone level. However, compared with female patients, trabecular microstructure tends to be more compromised in male patients.…”

Section: Discussionsupporting

confidence: 89%

Alterations of Bone Density, Microstructure, and Strength of the Distal Radius in Male Patients With Rheumatoid Arthritis: A Case-Control Study With HR-pQCT

Zhu

Griffith

Qin

et al. 2014

Journal of Bone and Mineral Research

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In this cross-sectional study, we investigated volumetric bone mineral density (vBMD), bone microstructure, and biomechanical competence of the distal radius in male patients with rheumatoid arthritis (RA). The study cohort comprised 50 male RA patients of average age of 61.1 years and 50 age-matched healthy males. Areal BMD (aBMD) of the hip, lumbar spine, and distal radius was measured by dual-energy X-ray absorptiometry. High-resolution peripheral quantitative computed tomography (HR-pQCT) of the distal radius provided measures of cortical and trabecular vBMD, microstructure, and biomechanical indices. aBMD of the hip but not the lumbar spine or ultradistal radius was significantly lower in RA patients than controls after adjustment for body weight. Total, cortical, and trabecular vBMD at the distal radius were, on average, -3.9% to -23.2% significantly lower in RA patients, and these differences were not affected by adjustment for body weight, testosterone level, or aBMD at the ultradistal radius. Trabecular microstructure indices were, on average, -8.1% (trabecular number) to 28.7% (trabecular network inhomogeneity) significantly inferior, whereas cortical pore volume and cortical porosity index were, on average, 80.3% and 63.9%, respectively, significantly higher in RA patients. RA patients also had significantly lower whole-bone stiffness, modulus, and failure load, with lower and more unevenly distributed cortical and trabecular stress. Density and microstructure indices significantly correlated with disease activity, severity, and levels of pro-inflammatory cytokines (interleukin [IL] 12p70, tumor necrosis factor, IL-6 and IL-1b). Ten RA patients had focal periosteal bone apposition most prominent at the ulnovolar aspect of the distal radius. These patients had shorter disease duration and significantly higher cortical porosity. In conclusion, HR-pQCT reveals significant alterations of bone density, microstructure, and strength of the distal radius in male RA patients and provides new insight into the microstructural basis of bone fragility accompanying chronic inflammation.

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Section: Discussionsupporting

confidence: 89%

Alterations of Bone Density, Microstructure, and Strength of the Distal Radius in Male Patients With Rheumatoid Arthritis: A Case-Control Study With HR-pQCT

Zhu

Griffith

Qin

et al. 2014

Journal of Bone and Mineral Research

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“…It is known that the cortical structure is affected by different types of arthritis1819202122 and in this paper we demonstrate that changes of both the average thickness and the longitudinal gradient of the thickness of the cortical bone are affected by experimental arthritis. We successfully overcame the technical difficulties related to obtaining this measure in a setting of μ CT scans of murine hind paws.…”

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confidence: 53%

“…Another advantage of using the larger bones is that the trabecular compartments may also be analysed1822. The loss of trabecular bone mass is another factor that is commonly shown to correlate with RA1922, but for in vivo μ CT images of the metatarsals the resolution is not high enough to determine the trabecular structure. There has been progress in identifying single bones from CT and MRI of the carpus26272829, but these studies are not coupled with automatic determination of bone degradation.…”

mentioning

confidence: 99%

Quantification of arthritic bone degradation by analysis of 3D micro-computed tomography data

Svensson

Hoffmann

Irmler

et al. 2017

Sci Rep

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The use of animal models of arthritis is a key component in the evaluation of therapeutic strategies against the human disease rheumatoid arthritis (RA). Here we present quantitative measurements of bone degradation characterised by the cortical bone profile using glucose-6-phosphate isomerase (G6PI) induced arthritis. We applied micro-computed tomography (μCT) during three arthritis experiments and one control experiment to image the metatarsals of the hind paws and to investigate the effect of experimental arthritis on their cortical bone profile. For measurements of the cortical profile we automatically identified slices that are orthogonal to individual metatarsals, thereby making the measurements independent of animal placement in the scanner. We measured the average cortical thickness index (CTI) of the metatarsals, as well as the thickness changes along the metatarsal. In this study we introduced the cortical thickness gradient (CTG) as a new measure and we investigated how arthritis affects this measure. We found that in general both CTI and CTG are able to quantify arthritic progression, whilst CTG was found to be the more sensitive measure.

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“…Measurements at the ultradistal radius were carried out 9.5 mm proximal to the reference line, as described . For the periarticular radius the reference line was set through the edge of the medial part of the radio‐carpal joint . The volumes of interest for both sites are shown in Fig.…”

Section: Methodsmentioning

confidence: 99%

Quantitative and Qualitative Changes of Bone in Psoriasis and Psoriatic Arthritis Patients

Kocijan

Englbrecht

Haschka

et al. 2015

Journal of Bone and Mineral Research

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Psoriatic arthritis (PsA) is a chronic inflammatory disease characterized by periarticular bone loss and new bone formation. Current data regarding systemic bone loss and bone mineral density (BMD) in PsA are conflicting. The aim of this study was to evaluate bone microstructure and volumetric BMD (vBMD) in patients with PsA and psoriasis. We performed HR-pQCT scans at the ultradistal and periarticular radius in 50 PsA patients, 30 psoriasis patients, and 70 healthy, age- and sex-related controls assessing trabecular bone volume (BV/TV), trabecular number (Tb.N), inhomogeneity of the trabecular network, cortical thickness (Ct.Th), and cortical porosity (Ct.Po), as well as vBMD. Trabecular BMD (Tb.BMD, p = 0.021, 12.0%), BV/TV (p = 0.020, -11.9%), and Tb.N (p = 0.035, 7.1%) were significantly decreased at the ultradistal radius and the periarticular radius in PsA patients compared to controls. In contrast, bone architecture of the ultradistal radius and periarticular radius was similar in patients with psoriasis and healthy controls. Duration of skin disease was associated with low BV/TV and Tb.N in patients with PsA. These data suggest that trabecular BMD and bone microstructure are decreased in PsA patients. The observation that duration of skin disease determines bone loss in PsA supports the concept of subclinical musculoskeletal disease in psoriasis patients.

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Decreased Quantity and Quality of the Periarticular and Nonperiarticular Bone in Patients With Rheumatoid Arthritis: A Cross-Sectional HR-pQCT Study

Cited by 55 publications

References 49 publications

Alterations of Bone Density, Microstructure, and Strength of the Distal Radius in Male Patients With Rheumatoid Arthritis: A Case-Control Study With HR-pQCT

Alterations of Bone Density, Microstructure, and Strength of the Distal Radius in Male Patients With Rheumatoid Arthritis: A Case-Control Study With HR-pQCT

Quantification of arthritic bone degradation by analysis of 3D micro-computed tomography data

Quantitative and Qualitative Changes of Bone in Psoriasis and Psoriatic Arthritis Patients

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