Metacarpal bone loss in patients with rheumatoid arthritis estimated by a new Digital X-ray Radiogrammetry method – initial results

Abstract

BackgroundThe Digital X-ray Radiogrammetry (DXR) method measures the cortical bone thickness in the shafts of the metacarpals and has demonstrated its relevance in the assessment of hand bone loss caused by rheumatoid arthritis (RA). The aim of this study was to validate a novel approach of the DXR method in comparison with the original version considering patients with RA.MethodThe study includes 49 patients with verified RA. The new version is an extension of the BoneXpert method commonly used in pediatrics which has these characteristics: (1) It introduces a new technique to analyze the images which automatically validates the results for most images, and (2) it defines the measurement region relative to the ends of the metacarpals. The BoneXpert method measures the Metacarpal Index (MCI) at the metacarpal bone (II to IV). Additionally, the MCI is quantified by the DXR X-posure System.ResultsThe new version correctly analyzed all 49 images, and 45 were automatically validated. The standard deviation between the MCI results of the two versions was 2.9% of the mean MCI. The average Larsen score was 2.6 with a standard deviation of 1.3. The correlation of MCI to Larsen score was −0.81 in both versions, and there was no significant difference in their ability to detect erosions.ConclusionThe new DXR version (BoneXpert) validated 92% of the cases automatically, while the same good correlation to RA severity could be presented compared to the old version.

Sex and External Size Specific Limitations in Assessing Bone Health From Adult Hand Radiographs

“…Knowing these limitations may help plan clinical and research studies comparing males and females and screening for fracture risk. (43)(44)(45) Some limitations of this study are important to discuss. First, the cadaveric collection was limited to adult white male and female donors.…”

“…Given that identifying individuals with poor bone health is critical for optimizing treatments and reducing fracture risk, ( 11 ) additional studies are warranted to determine if the morphology‐strength associations reported herein represent those of populations of clinical interest. ( 44 ) Finally, we focused exclusively on metacarpal morphology which can be measured from hand radiographs. However, whole‐bone strength also depends on tissue‐level mechanical properties.…”

“…Knowing these limitations may help plan clinical and research studies comparing males and females and screening for fracture risk. ( 43–45 )…”

Bone erosion in the 2nd metacarpophalangeal head: association with its bone mineral density by HR-pQCT in rheumatoid arthritis patients

“…Besides that, through MIAF, the software we used here for bone erosions analysis, it was possible quantifying precisely both bone erosions in cubic millimeters (mm 3 ) and periarticular bone loss [ 20 , 28 ], as well as focal BMD around erosions [ 14 ]. Digital x-ray radiogrammetry is another method frequently used in many studies to assess hand or MCP BMD in arthritis patients, showing a good correlation between local bone loss and disease progression, but this still represents a semiquantitative method [ 7 , 29 , 30 ].…”

Die periartikuläre Demineralisation bei rheumatoider Arthritis

“…EineBestimmungderKnochenmineraldichteanhandvonRönt genaufnahmen im Bereich der Metakarpalknochen ist durch die DigitaleRadiogrammetrieetabliert [19,20].DieDigitaleRadio grammetrie basiert auf einer computerbasierten Analyse (Digital X-rayRadiogrammetry[DXR],z.B.Pronosco ® /SectraSystem bzw. Bone Xpert-System)vonHandröntgenaufnahmenmiteinerQuanti fizierungderKnochenmineraldichteimBereichderMetakarpalkno chenII-IV [21,22].DieDigitaleRadiogrammetrieistdurcheine hohe Reproduzierbarkeit der Messergebnisse (DXRBMD -Varia tionskoeffizient:0,13%-1,50%)gekennzeichnet [23].…”