Digital x‐ray radiogrammetry combined with semiautomated analysis of joint space widths as a new diagnostic approach in rheumatoid arthritis: A cross‐sectional and longitudinal study

Abstract

Objective. To evaluate digital x-ray radiogrammetry (DXR) and the Radiogrammetry Kit program as new diagnostic tools for quantifying disease-related periarticular osteoporosis and for measuring joint space narrowing according to the severity and duration of rheumatoid arthritis (RA).Methods. Using DXR, we performed computerized calculations of bone mineral density (BMD) and the metacarpal index (MCI) in 258 patients with active RA. Using the Radiogrammetry Kit program, we also performed semiautomated measurements of joint space width(JSW)atthesecondthroughthefifthmetacarpophalangeal (MCP) joints in these patients.Results. All correlations between the different parameters of both techniques (BMD and the MCI as measured by DXR and MCP JSW as measured by the Radiogrammetry Kit) were significant (0.36 < R < 0.63; P < 0.01). As expected, a significant negative association was shown between the different MCP JSW results and the results of all scoring methods (؊0.67 < R < ؊0.29). The BMD and the MCI measured by DXR both decreased significantly between Steinbrocker stage I and stage IV (by 32.7% and 36.6%, respectively; both P < 0.01). Reductions in the overall (mean) MCP JSW varied from 35.3% (Larsen score) to 52.9% (Steinbrocker stage). Over a period of 6 years, we observed relative decreases in BMD and the MCI as measured by DXR (32.1% and 33.3%, respectively), as well as in the overall (mean) MCP JSW (23.5%), and these were pronounced in early RA (duration <1 year). In addition, excellent reproducibility of DXR and Radiogrammetry Kit parameters was verified (coefficients of variation <1%).Conclusion. DXR with the integrated Radiogrammetry Kit program could be a promising, widely available diagnostic tool for supplementing the different RA scoring methods with quantitative data, thus allowing an earlier and improved diagnosis of RA and more precision in determining disease progression.

Osteoporosis in inflammatory joint diseases

“…In contrast, no change was measured at the spine and femoral neck in this small group of 13 patients. Hand BMD has been proposed as outcome measure in early RA [41][42][43][44][45][46][47]. In theory, the best sites to measure this bone loss would be around the metacarpophalangeal and proximal interphalangeal joints; however, most of the studies report the whole hand BMD because of a better precision and because of a better assessment of the whole inflammatory process of all the joints [46].…”

Metacarpal thickness, width, length and medullary diameter in children—reference curves from the First Zürich Longitudinal Study

“…Recent radiogrammetric studies have mostly focussed on composite indices which have been formulated to correlate with the mass and hence strength of long bones [1][2][3][4]. Comparatively little attention has been given to the parameters that make up such indices.…”

Automatic image analysis for decision support in rheumatoid arthritis and osteoporosis

“…Joint space width of interphalangeal joints was measured as an average over a width of 5.5 mm in the center of the joint. The interphalangeal joint analysis was a further development of the semi-automatic method used in [42] and [43].…”