{"title":"使用 HR-pQCT 对类风湿性关节炎患者的掌指关节进行微结构分析：与健康对照组的比较。","authors":"Kounosuke Watanabe , Ko Chiba , Kazuteru Shiraishi , Takeshi Iida , Naoki Iwamoto , Akihiko Yonekura , Atsushi Kawakami , Makoto Osaki","doi":"10.1016/j.bone.2024.117250","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To investigate which joint microarchitectural parameters measured by high-resolution peripheral quantitative computed tomography (HR-pQCT) serve as imaging markers for rheumatoid arthritis (RA).</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>There were no differences in joint space parameters between RA patients and HCs.</p><p>For bone microarchitecture, RA patients had lower trabecular bone mineral density (127 vs. 167 mg/cm<sup>3</sup>), 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<sup>3</sup>) than HCs.</p><p>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<sup>3</sup>), and longer width (2.40 vs. 1.82 mm) and longer length (2.34 vs. 1.64 mm) than HCs.</p><p>Most of the erosions in HCs were <5 mm<sup>3</sup> in volume (95 %) and located on the radial side (85 %). When erosions <5 mm<sup>3</sup> were compared between RA patients and HCs, there were no differences in their location or morphology.</p></div><div><h3>Conclusions</h3><p>Deterioration of bone microarchitecture and existences of erosions >5 mm<sup>3</sup> in the MCP joints are sensitive imaging markers of RA. Erosions <5 mm<sup>3</sup> in RA patients may include not only early pathological erosion but also physiological erosion because even HCs can have erosions <5 mm<sup>3</sup>.</p></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"189 ","pages":"Article 117250"},"PeriodicalIF":3.5000,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Microarchitectural analysis of the metacarpophalangeal joint using HR-pQCT in patients with rheumatoid arthritis: A comparison with healthy controls\",\"authors\":\"Kounosuke Watanabe , Ko Chiba , Kazuteru Shiraishi , Takeshi Iida , Naoki Iwamoto , Akihiko Yonekura , Atsushi Kawakami , Makoto Osaki\",\"doi\":\"10.1016/j.bone.2024.117250\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>To investigate which joint microarchitectural parameters measured by high-resolution peripheral quantitative computed tomography (HR-pQCT) serve as imaging markers for rheumatoid arthritis (RA).</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>There were no differences in joint space parameters between RA patients and HCs.</p><p>For bone microarchitecture, RA patients had lower trabecular bone mineral density (127 vs. 167 mg/cm<sup>3</sup>), 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<sup>3</sup>) than HCs.</p><p>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<sup>3</sup>), and longer width (2.40 vs. 1.82 mm) and longer length (2.34 vs. 1.64 mm) than HCs.</p><p>Most of the erosions in HCs were <5 mm<sup>3</sup> in volume (95 %) and located on the radial side (85 %). When erosions <5 mm<sup>3</sup> were compared between RA patients and HCs, there were no differences in their location or morphology.</p></div><div><h3>Conclusions</h3><p>Deterioration of bone microarchitecture and existences of erosions >5 mm<sup>3</sup> in the MCP joints are sensitive imaging markers of RA. Erosions <5 mm<sup>3</sup> in RA patients may include not only early pathological erosion but also physiological erosion because even HCs can have erosions <5 mm<sup>3</sup>.</p></div>\",\"PeriodicalId\":9301,\"journal\":{\"name\":\"Bone\",\"volume\":\"189 \",\"pages\":\"Article 117250\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2024-09-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Bone\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S8756328224002394\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Bone","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S8756328224002394","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
摘要
目的：研究高分辨率外周定量计算机断层扫描（HR-pQCT）测量的哪些关节微结构参数可作为类风湿性关节炎（RA）的影像学标记：研究通过高分辨率外周定量计算机断层扫描（HR-pQCT）测量的哪些关节微结构参数可作为类风湿性关节炎（RA）的影像学标记：使用 HR-pQCT 扫描了 50 名 RA 患者和 50 名健康对照者（HCs）（年龄在 50-79 岁之间，均为女性）的第二和第三掌指关节（MCP）。对关节间隙、骨小梁微结构和侵蚀情况进行了测量，并对 RA 患者和 HCs 进行了比较：结果：RA 患者和 HCs 的关节间隙参数没有差异。在骨微结构方面，与 HCs 相比，RA 患者的骨小梁骨矿物质密度较低（127 vs. 167 mg/cm3），骨小梁厚度较薄（0.20 vs. 0.21 mm），骨小梁数量较少（1.49 vs. 1.55 /mm），杆状结构较多（1.68 vs. 1.23），骨小梁连接性较差（4.51 vs. 5.72 /mm3）。在侵蚀方面，RA 患者每个关节的侵蚀数量（36/100 对 18/100）、体积（4.62 对 1.89 mm3）、宽度（2.40 对 1.82 mm）和长度（2.34 对 1.64 mm）均高于 HC 患者。HCs 中的大多数糜烂体积为 3（95%），位于桡侧（85%）。当对RA患者和HC患者的侵蚀3进行比较时，其位置和形态均无差异：结论：骨微结构的恶化和 MCP 关节中大于 5 mm3 的侵蚀是 RA 的敏感影像学标志。RA患者的侵蚀3不仅包括早期病理侵蚀，还可能包括生理性侵蚀，因为即使是HCs也可能存在侵蚀3。
Microarchitectural analysis of the metacarpophalangeal joint using HR-pQCT in patients with rheumatoid arthritis: A comparison with healthy controls
Objective
To investigate which joint microarchitectural parameters measured by high-resolution peripheral quantitative computed tomography (HR-pQCT) serve as imaging markers for rheumatoid arthritis (RA).
Methods
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.
Results
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/cm3), 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 /mm3) 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 mm3), 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 mm3 in volume (95 %) and located on the radial side (85 %). When erosions <5 mm3 were compared between RA patients and HCs, there were no differences in their location or morphology.
Conclusions
Deterioration of bone microarchitecture and existences of erosions >5 mm3 in the MCP joints are sensitive imaging markers of RA. Erosions <5 mm3 in RA patients may include not only early pathological erosion but also physiological erosion because even HCs can have erosions <5 mm3.
期刊介绍：
BONE is an interdisciplinary forum for the rapid publication of original articles and reviews on basic, translational, and clinical aspects of bone and mineral metabolism. The Journal also encourages submissions related to interactions of bone with other organ systems, including cartilage, endocrine, muscle, fat, neural, vascular, gastrointestinal, hematopoietic, and immune systems. Particular attention is placed on the application of experimental studies to clinical practice.
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