TY - JOUR
T1 - The minimal erosive volume needed for radiographic identification of erosions in the metacarpophalangeal joints in patients with rheumatoid arthritis
AU - Klose-Jensen, Rasmus
AU - Therkildsen, Josephine
AU - Blavnsfeldt, Anne-Birgitte Garm
AU - Langdahl, Bente Lomholt
AU - Zejden, Anna
AU - Thygesen, Jesper
AU - Keller, Kresten Krarup
AU - Hauge, Ellen-Margrethe
PY - 2023/4
Y1 - 2023/4
N2 - Objective. To compare in images, obtained by high-resolution peripheral quantitative computed tomography (HR-pQCT) and conventional radiography (CR) of the second and third metacarpophalangeal (MCP) joints, the minimal erosive cortical break needed to differentiate between pathological and physiological cortical breaks. Methods. In this single-center cross-sectional study, patients with established rheumatoid arthritis (disease duration ≥ 5 yrs) had their second and third MCP joints of the dominant hand investigated by HR-pQCT and CR. Empirical estimation was used to find the optimal cut-off value for the number of erosions and total erosive volume, which were detectable between patients with and without erosions in the second and third MCP joints according to CR. Results. The total erosive volume in the second and third MCP joints by HR-pQCT for CR-detected erosive disease was estimated to be 56.4 mm
3 (95% CI 3.5-109.3). The sensitivity and specificity at this cutpoint were 78% and 83%, respectively, with an area under the receiver-operating characteristic curve (AUC) of 0.81. The optimal cut-off value for the number of erosions by HR-pQCT was 8.5 (95% CI 5.9-11.1) for CR-detected erosive disease in the second and third MCP joints. The sensitivity and specificity at this cutpoint were 74% and 88%, respectively, with an AUC of 0.81. Conclusion. Erosions by HR-pQCT were larger in patients with erosive damage in the second and third MCP joints by CR. We found that CR had poor sensitivity for detecting erosive disease when the erosive volume was < 56.4 mm
3 or the number of erosions was < 8.5.
AB - Objective. To compare in images, obtained by high-resolution peripheral quantitative computed tomography (HR-pQCT) and conventional radiography (CR) of the second and third metacarpophalangeal (MCP) joints, the minimal erosive cortical break needed to differentiate between pathological and physiological cortical breaks. Methods. In this single-center cross-sectional study, patients with established rheumatoid arthritis (disease duration ≥ 5 yrs) had their second and third MCP joints of the dominant hand investigated by HR-pQCT and CR. Empirical estimation was used to find the optimal cut-off value for the number of erosions and total erosive volume, which were detectable between patients with and without erosions in the second and third MCP joints according to CR. Results. The total erosive volume in the second and third MCP joints by HR-pQCT for CR-detected erosive disease was estimated to be 56.4 mm
3 (95% CI 3.5-109.3). The sensitivity and specificity at this cutpoint were 78% and 83%, respectively, with an area under the receiver-operating characteristic curve (AUC) of 0.81. The optimal cut-off value for the number of erosions by HR-pQCT was 8.5 (95% CI 5.9-11.1) for CR-detected erosive disease in the second and third MCP joints. The sensitivity and specificity at this cutpoint were 74% and 88%, respectively, with an AUC of 0.81. Conclusion. Erosions by HR-pQCT were larger in patients with erosive damage in the second and third MCP joints by CR. We found that CR had poor sensitivity for detecting erosive disease when the erosive volume was < 56.4 mm
3 or the number of erosions was < 8.5.
KW - computed tomography
KW - joint erosions
KW - metacarpophalangeal joint
KW - radiology
KW - rheumatoid arthritis
UR - http://www.scopus.com/inward/record.url?scp=85151574778&partnerID=8YFLogxK
U2 - 10.3899/jrheum.220623
DO - 10.3899/jrheum.220623
M3 - Journal article
C2 - 36379577
SN - 0315-162X
VL - 50
SP - 469
EP - 477
JO - The Journal of Rheumatology
JF - The Journal of Rheumatology
IS - 4
ER -