Inflammatory Bone Spur Formation in Psoriatic Arthritis Is Different From Bone Spur Formation in Hand Osteoarthritis

Abstract

Objective. To investigate the different patterns of bone spur formation in psoriatic arthritis (PsA) and hand osteoarthritis (OA), using high-resolution peripheral quantitative computed tomography (QCT).Methods. The study group comprised 70 subjects (25 patients with PsA, 25 patients with hand OA, and 20 healthy controls). The 2 patient groups were similar with regard to age and sex distribution and clinical involvement of the metacarpophalangeal (MCP) joints. All patients underwent high-resolution peripheral QCT scanning of the second, third, and fourth MCP joints of the dominantly affected hand. Demographic and disease-specific data were recorded, and the number, size, and distribution of bone spurs were assessed and compared between patients with PsA and patients with hand OA.Results. The overall number and size of bone spurs were similar in patients with PsA and patients with hand OA. However, localization of lesions within individual joints was substantially different between patients with PsA and those with hand OA. In PsA, bone spurs dominated the radial sides of the joints (for the metacarpal head of the second joint, P < 0.001 versus hand OA; for the base of the second phalangeal joint, P < 0.001 versus hand OA), whereas the palmar and dorsal quadrants were the predilection sites in hand OA. Detailed anatomic analysis showed that bone spurs in the entheseal regions were prominent in patients with PsA but rare in patients with hand OA, and that bone spurs in patients with hand OA typically emerged at the cartilage-bone interphase and the joint margins.Conclusion. Our findings show that the overall number and size of bone spurs are similar in patients with PsA and patients with hand OA. Nonetheless, the anatomic sites of bone proliferation are different between these 2 groups of patients.

Osteoarthritis year in review 2015: clinical

“…While overall number and size of bone spurs were similar in patients with psoriatic arthritis and hand OA in a study in Germany utilizing high-resolution peripheral quantitative computer tomography, anatomic sites differed: in psoriatic arthritis, radial side; and in OA, palmar and dorsal quadrants (31). …”

High-resolution peripheral quantitative CT in rheumatology

“…3 Due to its ability to evaluate bone in 3D at a high resolution (82 μm) and with minimal irradiation (5 μSv to image a 0.9 cm region of interest), HR-pQCT is being intensely investigated in the evaluation of bone architecture in the small joints of the hands in rheumatoid arthritis, 4-6 psori atic arthritis, 7 and hand osteoarthritis. 8 To what degree can this method now be rated as "progress in imaging" in rheumatology?…”

“…3 Due to its ability to evaluate bone in 3D at a high resolution (82 μm) and with minimal irradiation (5 μSv to image a 0.9 cm region of interest), HR-pQCT is being intensely investigated in the evaluation of bone architecture in the small joints of the hands in rheumatoid arthritis, 4-6 psori atic arthritis, 7 and hand osteoarthritis. 8 To what degree can this method now be rated as "progress in imaging" in rheumatology?Firstly, an increased number of, and earlier stages of, erosions are visible with HR-pQCT than on plain radiography, as evidenced by the work of Stach et al 4 Secondly, quantification of erosions in terms of size (width, depth and volume) together with changes in trabecular bone is possible, and has been studied in crosssectional and longitudinal studies 5,9-11 and in comparison with MRI. 6 Thirdly, a 3D assessment of joint space is described using quantitative analysis algorithms.…”

Bone remodeling in psoriasis and psoriatic arthritis

“…Comparative analysis of bone spurs in PsA and hand osteoarthritis by HR-pQCT revealed that although similarities exist in terms of overall number and size of bone spurs in PsA and hand osteoarthritis, the localization of lesions in individual joints differed substantially when comparing the two disorders. Although bone spurs in hand osteoarthritis are typically located at the cartilage-bone interface and joint margins, bone spurs in PsA patients are prominent in the enthesial region [3]. In another study, analysis of bone using HR-pQCT in patients with cutaneous psoriasis without any clear sign of joint manifestation revealed enthesiophyte formation even in the absence of apparent clinical joint involvement.…”