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High-resolution peripheral quantitative computed tomography for the evaluation of bone erosions of metatarsophalangeal joints in patients with rheumatoid arthritis

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Objectives: To compare if the 4th and 5th metatarsophalangeal (MTP) joints evaluated by high-resolution peripheral quantitative computed tomography (HR-pQCT) could classify more patients with erosive rheumatoid arthritis (RA) compared with conventional radiography (CR) of the hands, wrists, and feet. Furthermore, we characterize and quantify bone erosions in the two MTP joints by HR-pQCT. Methods: This single-center cross-sectional study included patients with established RA (disease duration ≥5 years). Blinded to patient data, the number and volume of erosions in the 4th and 5th MTP joints were measured by HR-pQCT, whereas the erosive scores by CR of 44 joints in the hands, wrists, and feet were assessed according to the Sharp/van der Heijde method. Results: Among 42 participants, 30 patients were classified with erosive RA and 12 with non-erosive RA by CR. HR-pQCT of two MTP joints could classify more patients with erosive RA compared with CR of 44 joints (p =.03). The optimal cut-off value for the number and volume of erosions per patient in the 4th and 5th MTP joints by HR-pQCT was 7.5 erosions and 11.7 mm3, respectively, for detecting erosive disease by CR. Erosions in the two MTP joints by HR-pQCT were found most frequently and were largest at the lateral quadrant of the 5th metatarsal head. Conclusion: The superiority of HR-pQCT of the 4th and 5th MTP joints compared with CR of 44 joints for classifying erosive RA provides a basis for larger studies evaluating if HR-pQCT could be used for diagnosing erosive RA in the future.

TidsskriftInternational Journal of Rheumatic Diseases
Sider (fra-til)1512-1520
Antal sider9
StatusUdgivet - aug. 2023

Bibliografisk note

Funding Information:
The authors are grateful for the valuable work in HR-pQCT scanning of the patients by Mathias Hänel, the splendid guidance in analyzing HR-pQCT scans by Jette Barlach, and for the excellent assistance in recruiting and scheduling the patients by Mia Birkelund Okkels, Marie Bækmark Kjær, Mia Marie Remmer, Lone Thomasen, and Else Sloth Rousing.

Funding Information:
The study has been financially supported by The Danish Rheumatism Association (R179‐A6365‐B1668, R196‐A6925‐B1668), Aarhus University, The Aarhus University Research Foundation, The Health Research Foundation of Central Denmark Region (R64‐A3145‐B1504, R49‐A2254‐B1504), The Beckett Fund (20‐2‐5756), The Novo Nordisk Foundation, The Aase and Ejnar Danielsens Fund (20‐10‐0254), The “Oldermand, slagtermester Peter Ryholts” Scholarship and A.P. Møller Fonden. The funding sources did not have any role in the collection, analysis, or interpretation of data. The Financial contributors had no role in the study design, collection, analysis, and interpretation of data, the writing of the manuscript or in the decision to submit the manuscript for publication.

Publisher Copyright:
© 2023 The Authors. International Journal of Rheumatic Diseases published by Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

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