TY - JOUR
T1 - Detecting new erosions in rheumatoid arthritis over one year – Radiography and high-resolution computed tomography of finger joints
AU - Therkildsen, Josephine
AU - Jensen, Rasmus Klose
AU - Hänel, Mathias
AU - Langdahl, Bente Lomholt
AU - Thomsen, Jesper Skovhus
AU - Manske, Sarah L.
AU - Keller, Kresten Krarup
AU - Hauge, Ellen Margrethe
PY - 2025/1
Y1 - 2025/1
N2 - Objective: To compare the number of new erosions in two metacarpophalangeal (MCP) joints over one year assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT) and conventional radiography (CR). Furthermore, to estimate the diagnostic accuracy of erosive progression by CR with HR-pQCT as the reference standard. Methods: Paired sets of image data were available from patients with RA (n = 310), who underwent HR-pQCT and CR, including the 2nd and 3rd MCP joints only of the dominant hand at baseline and at the one-year follow-up. Erosion number was determined using HR-pQCT and CR. Erosive volume was estimated from segmented HR-pQCT images, and erosion scores were obtained by the Sharp/van der Heijde method from CR. Erosive progression was defined as an increase in total erosion number or a study-specified increase in total erosive volume or total erosion score. Results: At baseline, 250 erosions were identified by CR compared to 1864 erosions by HR-pQCT. After one year, 3 new erosions were detected by CR compared to 66 new erosions by HR-pQCT. Erosive progression was identified in 40 patients using HR-pQCT and in 3 patients using CR. With HR-pQCT as reference, CR had a sensitivity of 2.5% (95% CI: 0.1–13.2%) and a specificity of 99.3% (95% CI: 97.3–99.9%) for detecting erosive progression. Conclusion: HR-pQCT identified more than 20 times the number of new erosions, and more than 10 times as many patients with erosive progression than CR. HR-pQCT is a sensitive tool for monitoring new erosions and erosive progression over one year in RA.
AB - Objective: To compare the number of new erosions in two metacarpophalangeal (MCP) joints over one year assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT) and conventional radiography (CR). Furthermore, to estimate the diagnostic accuracy of erosive progression by CR with HR-pQCT as the reference standard. Methods: Paired sets of image data were available from patients with RA (n = 310), who underwent HR-pQCT and CR, including the 2nd and 3rd MCP joints only of the dominant hand at baseline and at the one-year follow-up. Erosion number was determined using HR-pQCT and CR. Erosive volume was estimated from segmented HR-pQCT images, and erosion scores were obtained by the Sharp/van der Heijde method from CR. Erosive progression was defined as an increase in total erosion number or a study-specified increase in total erosive volume or total erosion score. Results: At baseline, 250 erosions were identified by CR compared to 1864 erosions by HR-pQCT. After one year, 3 new erosions were detected by CR compared to 66 new erosions by HR-pQCT. Erosive progression was identified in 40 patients using HR-pQCT and in 3 patients using CR. With HR-pQCT as reference, CR had a sensitivity of 2.5% (95% CI: 0.1–13.2%) and a specificity of 99.3% (95% CI: 97.3–99.9%) for detecting erosive progression. Conclusion: HR-pQCT identified more than 20 times the number of new erosions, and more than 10 times as many patients with erosive progression than CR. HR-pQCT is a sensitive tool for monitoring new erosions and erosive progression over one year in RA.
KW - Erosive progression
KW - Metacarpophalangeal joints
KW - Radiography
KW - Rheumatoid arthritis
KW - X-ray computed tomography
UR - http://www.scopus.com/inward/record.url?scp=85211025386&partnerID=8YFLogxK
U2 - 10.1016/j.jbspin.2024.105812
DO - 10.1016/j.jbspin.2024.105812
M3 - Journal article
C2 - 39547428
SN - 1297-319X
VL - 92
JO - Joint Bone Spine
JF - Joint Bone Spine
IS - 1
M1 - 105812
ER -