Study of vertebral fracture and Scanographic Bone Attenuation Coefficient in rheumatoid arthritis and ankylosing spondylitis vs. controls

Fauny, Marine; Albuisson, Éliane; Bauer, Elodie; Perrier-Cornet, J; Chary‐Valckenaere, Isabelle; Lœuille, Damien

doi:10.1038/s41598-019-49712-x

Cited by 16 publications

(26 citation statements)

References 34 publications

(37 reference statements)

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“…The reproducibility values of our measures were very good for mSASSS and for SBAC-L1 measurements 26 . The results are similar in the literature on radiography as well on CT, which supports the possibility of using SBAC-L1 in clinical practice 18 , 49 .…”

Section: Discussionmentioning

confidence: 61%

“…Demographic characteristics (age, gender, smoking…), clinical data (disease duration, activity score…), biological data (C-reactive protein (CRP)) and information about therapeutic treatments (calcium, vitamin D…) were collected from the complete medical records on about AS and osteoporosis 26 . Clinical risk factors of osteoporosis (gender, age, biological inflammation, smoking and corticosteroids) were also collected.…”

Section: Methodsmentioning

confidence: 99%

“…Osteoporosis is classically defined as a T-score ≤ -2.5 SD on DXA (standard deviation). We selected DXA and CT scan a maximum period of 2 years apart 26 .…”

Section: Methodsmentioning

confidence: 99%

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Relationship between spinal structural damage on radiography and bone fragility on CT in ankylosing spondylitis patients

Fauny

Verhoeven

Allado

et al. 2021

Sci Rep

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To evaluate whether the risk of bone fragility on computed tomography (CT) (scanographic bone attenuation coefficient of the first lumbar vertebra (SBAC-L1)) is associated with the severity of spine structural involvement (mSASSS) in patients with ankylosing spondylitis (AS). This retrospective study included AS patients, followed from 2009 to 2017, who fulfilled the New York criteria and who underwent thoraco-abdomino-pelvic CT and radiography (spine, pelvis). The structural involvement was retained for mSASSS ≥ 2. The SBAC-L1 was measured in Hounsfield units (HU). A SBAC-L1 ≤ 145 HU was used to define patients at risk of vertebral fracture (VF). A total of 73 AS patients were included (mean age: 60.3 (± 10.7) years, 8 women (11%), mean disease duration: 24.6 years (± 13.9)). Sixty patients (82.2%) had a mSASSS ≥ 2 (mean score 20.7 (± 21.2)). The mean SBAC-L1 was 141.1 HU (± 45), 138.1 HU (± 44.8) and 154.8 HU (± 44.9) in the total, mSASSS ≥ 2 and mSASSS < 2 populations, respectively. Patients with bone bridges had lower SBAC-L1 than mSASSS ≥ 2 patients without ankylosis (p = 0.02) and more often SBAC-L1 ≤ 145 HU (73% vs 41.9%, p = 0.006). A SBAC-L1 ≤ 145 HU was not associated with structural spine involvement, but patients with bone bridges had significantly decreased SBAC-L1 and an increased probability of being under the fracture threshold.

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Section: Discussionmentioning

confidence: 61%

Section: Methodsmentioning

confidence: 99%

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Relationship between spinal structural damage on radiography and bone fragility on CT in ankylosing spondylitis patients

Fauny

Verhoeven

Allado

et al. 2021

Sci Rep

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“…The use of SBAC is interesting in AS patients because this technique permits direct evaluation of the trabecular bone density, avoiding cortical artifacts, such as osteophytes and syndesmophytes, as well as other artifacts (vascular calcifications) frequently observed in elderly AS patients. Furthermore, the SBAC measure is very reproducible [23,40] and easy to perform. This method could be used in daily practice to consider initial opportunistic bone screening on CT scans already performed during AS patients' follow-up (treatment side effects, comorbidity evaluation, emergency, etc.).…”

Section: Discussionmentioning

confidence: 99%

Consequences of spinal ankylosis on bone trabecular fragility assessed on CT scans in patients with ankylosing spondylitis. A retrospective study

et al. 2020

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Background: Ankylosing spondylitis (AS) patients seems to be at risk of osteoporosis but bone screening is not often performed. The objective was to evaluate the effect of vertebral ankylosis on scanographic bone attenuation coefficient (SBAC) on lumbar vertebrae in AS patients. Patients and methods: This study included AS patients fulfilling New York criteria who underwent both thoraco-abdomino-pelvic computed tomography and X-rays during routine follow-up. The modified stoke ankylosing spondylitis spinal score (mSASSS) was scored on X-rays, and the presence of at least one syndesmophyte (mSASSS≥2) defined mSASSS+ patients. Ankylosis of a lumbar vertebra was defined by the presence of bone bridges to its two adjacent vertebrae. The SBAC was measured from L1 to L5, and the fracture threshold was set at SBAC£145 HU. Results: A total of 73 AS patients were included (mean age: 60.3 (±10.7) years, 65 men (89%)). Sixty patients (82.2%) were mSASSS+; 13 patients (17.8%) presented ankylosis of at least one lumbar vertebra. The SBAC of each lumbar vertebra was not significantly different between mSASSS-and mSASSS+ patients. The SBAC was lower for patients with at least one bone bridge than for patients without (p<0.05). Patients with lumbar vertebral ankylosis had a higher risk of presenting an SBAC≤145 HU (OR: 4.95 (95% CI: 1.1-17.4)). Conclusion: The presence of a bone bridge and complete ankylosis of lumbar vertebra were associated with a higher risk of SBAC under the fracture threshold, suggesting structural deterioration of trabecular bone in ankylosed vertebrae in AS patients.

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“…In addition, there is pre-existing evidence indicating that in the presence of systemic inflammation, bone loss and reduced BMD can be seen due to the interaction of inflammatory mediators (interleukin, cytokines, etc.) with bone cells leading to the activation of osteoclasts through the receptor activator of nuclear factor-κB ligand (RANKL) system ( 16 ). Many studies have measured cardiac markers, such as the cardiothoracic ratio, pulmonary artery diameter, epicardial adipose tissue and coronary artery calcification, liver density for hepatic steatosis, and muscle volume in the musculoskeletal system in the prediction of prognosis in the CT scans of patients with COVID-19.…”

Section: Introductionmentioning

confidence: 99%

The Prognostic Value of Vertebral Bone Density on Chest CT in Hospitalized COVID-19 Patients

Tahtabaşı

Kilicaslan

Akın

et al. 2021

Journal of Clinical Densitometry

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Purpose : To evaluate the prognostic value of the vertebral bone mineral density (BMD) on chest computed tomography (CT) in COVID-19 patients. Methods : The chest CT of hospitalized patients with COVID-19 pneumonia were evaluated for Pneumonia Severity Score (PSS) as the ratio of the volume of involved lung parenchyma to the total lung volume. In addition, BMD was manually measured from the vertebral corpus using axial CT images. The relationships of clinical variables, PSS and vertebral BMD with patient outcomes, namely mortality, intensive care unit (ICU) admission and mechanical ventilation were investigated. Lower BMD was defined as ≤100 HU. Results : The study included 209 patients (118 males, 56.4%). As a result of the univariate analysis, the rates of mortality, ICU admission and mechanical ventilation were 17.2% (n=36), 24.8% (n=52), and 20.6% (n=43), respectively, and they were significantly higher among the patients with lower BMD (38.1 vs. 13.0%, p <0.001; 33.4 vs. 21.2%, p =0.002; and 38.1 vs. 8.2%, p <0.001, respectively). In the mortality group, PSS was significantly higher (median, 9 vs. 5; p <0.001) and vertebral BMD was significantly lower (median, 83 vs. 139; p <0.001). Severe clinical incidence was significantly higher in patients with lower BMD compared to those with higher BMD (39.7 vs 24.7% and p =0.028). There was a significant correlation between clinical classification and lower BMD (r=0.152 and p =0.028). The multivariate analysis revealed vertebral BMD [odds ratio (OR), 1.028; 95% CI, 1.011-1.045, p =0.001) and lower BMD (OR, 4.682; 95% CI, 1.784-12.287, p =0.002) as significant independent predictors of mortality. Conclusion : Vertebral BMD is a strong independent predictor of mortality that is reproducible and can be easily evaluated on the chest CT images of COVID-19 patients.

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Study of vertebral fracture and Scanographic Bone Attenuation Coefficient in rheumatoid arthritis and ankylosing spondylitis vs. controls

Cited by 16 publications

References 34 publications

Relationship between spinal structural damage on radiography and bone fragility on CT in ankylosing spondylitis patients

Relationship between spinal structural damage on radiography and bone fragility on CT in ankylosing spondylitis patients

Consequences of spinal ankylosis on bone trabecular fragility assessed on CT scans in patients with ankylosing spondylitis. A retrospective study

The Prognostic Value of Vertebral Bone Density on Chest CT in Hospitalized COVID-19 Patients

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