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Digital X-ray radiogrammetry and its sensitivity and specificity for the identification of rheumatoid arthritis-related cortical hand bone loss

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Journal of Bone and Mineral Metabolism Aims and scope Submit manuscript

Abstract

Digital X-ray radiogrammetry (DXR) is a computer-assisted diagnosis technique for quantifying cortical hand bone mineral density (BMD) as well as the metacarpal index (MCI) in the metacarpal bones from radiographs. The objective was to compare DXR-BMD and DXR-MCI between healthy individuals and patients with rheumatoid arthritis (RA) and verify the sensitivity and specificity of this technique for the identification of cortical hand bone loss as an additional diagnostic approach in RA. 618 patients were enrolled and divided into two groups: those with RA (n = 309) and a healthy control group (n = 309) as a reference database. DXR-BMD and the DXR-MCI were measured by DXR using hand radiographs. The severity of RA was evaluated by the modified Larsen score. Mean values for DXR-BMD and DXR-MCI in RA patients were significantly lower compared to healthy subjects (−20.7 and −21.1 %, respectively). Depending on the severity of RA-related joint damage, DXR-BMD revealed a significant reduction of –28.1 % and DXR-MCI –28.2 %, comparing score 1 and score 5 of the modified Larsen score. Both DXR-BMD and DXR-MCI had a high sensitivity (DXR-BMD 91 %, DXR-MCI 87 %) and a moderate specificity (DXR-BMD 47 %, DXR-MCI 49 %) to identify RA-related cortical hand bone loss. The DXR technique seems to be able to quantify RA-related periarticular bone loss as a characteristic feature in the course of RA. Consequently, periarticular osteoporosis seems to function as a reliable diagnostic approach comparable to erosions and joint space narrowing in the diagnosis of RA and as a surrogate marker for the progression of bone loss in RA.

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Article Open access 01 July 2023

Enisa Shevroja, Jean-Yves Reginster, … Nicholas C. Harvey

Abbreviations

BMD:

Bone mineral density (g/cm2)

DXR:

Digital X-ray radiogrammetry

MCI:

Metacarpal index

RA:

Rheumatoid arthritis

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Acknowledgments

The authors thank Monika Arens (managing director, Arewus GmbH) and Jacob Algulin (managing director, Sectra, Sweden) for the use of the Digital X-ray Radiogrammetry technique. Further thanks to Thomas Lehmann (PhD) for statistical advice.

Conflict of interest

The authors declare that they have no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Internal Medicine III, Jena University Hospital, Friedrich-Schiller-University Jena, Erlanger Allee 101, 07747, Jena, Germany

    Alexander Pfeil, Lisa Reinhardt & Gunter Wolf

  2. Norwegian University of Science and Technology, Trondheim, Norway

    Glenn Haugeberg

  3. Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Friedrich-Schiller-University Jena, Erlanger Allee 101, 07747, Jena, Germany

    Diane M. Renz

  4. Department of Medicine, Division of Cardiology, Pulmonology and Vascular Medicine, University Hospital Duesseldorf, Moorenstraße 5, 40225, Duesseldorf, Germany

    Christian Jung

  5. Department of Internal Medicine I, Jena University Hospital, Friedrich-Schiller-University Jena, Erlanger Allee 101, 07747, Jena, Germany

    Marcus Franz

  6. Institute of Diagnostic and Interventional Radiology, SRH Wald-Klinikum Gera, Straße des Friedens 122, 07548, Gera, Germany

    Joachim Böttcher

Authors
  1. Alexander Pfeil
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  2. Glenn Haugeberg
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  3. Diane M. Renz
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  4. Lisa Reinhardt
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  7. Gunter Wolf
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  8. Joachim Böttcher
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Corresponding author

Correspondence to Alexander Pfeil.

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Pfeil, A., Haugeberg, G., Renz, D.M. et al. Digital X-ray radiogrammetry and its sensitivity and specificity for the identification of rheumatoid arthritis-related cortical hand bone loss. J Bone Miner Metab 35, 192–198 (2017). https://doi.org/10.1007/s00774-016-0741-3

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  • DOI: https://doi.org/10.1007/s00774-016-0741-3

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