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

Author(s)

Figueiredo, Camille P. ^[1] ; Perez, Mariana O. ^[1] ; Sales, Lucas Peixoto ^[1] ; Medeiros, Ana Cristina ^[2] ; Caparbo, Valeria F. ^[1] ; Pereira, Rosa M. R. ^{[1, 2]}

Affiliation

^[1] Univ Sao Paulo, Div Rheumatol, Bone Metab Lab, Fac Med, FMUSP, Ave Dr Arnaldo 455, 3 Andar, Sala 3105, BR-01246903 Sao Paulo - Brazil

^[2] Univ Sao Paulo, Div Rheumatol, Hosp Clin, HCFMUSP, Fac Med, FMUSP, Sao Paulo, SP - Brazil

• Document type: Journal article
• Source: BMC MUSCULOSKELETAL DISORDERS; v. 22, n. 1 JAN 25 2021.
• Web of Science Citations: 0

Abstract

BackgroundRheumatoid arthritis (RA) is a chronic autoimmune disease depicted by synovial inflammation leading to local and systemic bone loss. The aim of this study was to evaluate by a HR-pQCT (High Resolution Peripheral Quantitative Computed Tomography) study which parameters are associated with volume of bone erosions including bone mineral density (BMD) around erosions (VOI 1 to 4=volume of interest), BMD of metacarpophalangeal (MCP) head, BMD of radius, presence of osteophytes and joint space width (JSW).MethodsFifty female RA patients (18-50years) were enrolled in this study. Demographic and disease-specific data, laboratory inflammatory parameters and handgrip test were performed. All patients underwent HR-pQCT of 2nd and 3rd MCP joints and distal radius, according to established protocols. The volume of bone erosions was evaluated by MIAF (Medical Image Analysis Framework) software. Osteophytes were analyzed by manual method.ResultsThe mean of age and disease duration were 40.06.0yrs. and 10.8 +/- 4.8yrs., respectively. According to DAS-28 (Disease Activity Score), 54% (27) of the sample were in remission. However, when SDAI (Simplified Disease Activity Index) was used, only 18% (9) were under remission. The mean of HAQ (Health Assessment Questionnaire), ESR (Erythrocyte sedimentation rate) and CRP (C reactive protein) were 0.9 +/- 0.7, 13.9 +/- 12.2mm and 5.6 +/- 7.5mg/mL, respectively. Forty-six bone erosions (0.9 +/- 1.2 erosion/patient) and 14 osteophytes (0.3 +/- 0.7 osteophyte/patient) were found in 2nd MCP head. The median (IQR-Interquartile range) of volume of erosion and volume of osteophytes were 14.9 (5.7;35.9)mm(3) and 3.1 (2.1, 4.3)mm(3), respectively. The mean of JSW was 80.5 +/- 34.2mm(3). The volume of bone erosions was negatively correlated with BMD of 2nd MCP head, VOI-4 and JSW; and it was positively correlated with osteophytes number. Regarding absence or presence of erosion in 2nd MCP head, a significant difference was found between BMD of MCP head, osteophyte number and JSW. Multiple linear regression analysis showed that only BMD of 2nd MCP head was independently associated with volume of bone erosions.ConclusionBMD of MCP head was independently associated with volume of bone erosion, suggesting that this parameter should be used to analyze and monitoring bone destruction, as well as to evaluate treatment response in RA patients. (AU)

• FAPESP's process: 18/01315-9 - Evaluation of bone metabolism parameters by HR-pQCT and histomorphometry in Rheumatoid Arthritis and Juvenile Idiopathic Arthritis patients: association with clinical and genetic variables
• Grantee: Camille Pinto Figueiredo
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• FAPESP's process: 16/00006-7 - Evaluation of bone metabolism parameters by HR-pQCT and histomorphometry in rheumatoid arthritis and juvenile idiopathic arthritis patients: association with clinical and genetic variables
• Grantee: Eduardo Ferreira Borba Neto
• Support Opportunities: Research Projects - Thematic Grants