The Minimal Erosive Volume Needed for Radiographic Identification of Erosions in the Metacarpophalangeal Joints in Patients With Rheumatoid Arthritis.

Autor:	Klose-Jensen R; R. Klose-Jensen, MD, PhD, J. Therkildsen, MD, A.B.G. Blavnsfeldt, MD, PhD, K.K. Keller, MD, PhD, E.M. Hauge, MD, PhD, Department of Rheumatology, Aarhus University Hospital, and Department of Clinical Medicine, Aarhus University; raujen@rm.dk., Therkildsen J; R. Klose-Jensen, MD, PhD, J. Therkildsen, MD, A.B.G. Blavnsfeldt, MD, PhD, K.K. Keller, MD, PhD, E.M. Hauge, MD, PhD, Department of Rheumatology, Aarhus University Hospital, and Department of Clinical Medicine, Aarhus University., Blavnsfeldt AG; R. Klose-Jensen, MD, PhD, J. Therkildsen, MD, A.B.G. Blavnsfeldt, MD, PhD, K.K. Keller, MD, PhD, E.M. Hauge, MD, PhD, Department of Rheumatology, Aarhus University Hospital, and Department of Clinical Medicine, Aarhus University., Langdahl B; B. Langdahl, MD, PhD, Department of Clinical Medicine, and Department of Endocrinology and Internal Medicine, Aarhus University., Zejden A; A. Zejden, MD, Department of Radiology, Aarhus University Hospital., Thygesen J; J. Thygesen, PhD, Department of Clinical Engineering, Central Denmark Region, CO Aarhus University Hospital, Aarhus, Denmark., Keller KK; R. Klose-Jensen, MD, PhD, J. Therkildsen, MD, A.B.G. Blavnsfeldt, MD, PhD, K.K. Keller, MD, PhD, E.M. Hauge, MD, PhD, Department of Rheumatology, Aarhus University Hospital, and Department of Clinical Medicine, Aarhus University., Hauge EM; R. Klose-Jensen, MD, PhD, J. Therkildsen, MD, A.B.G. Blavnsfeldt, MD, PhD, K.K. Keller, MD, PhD, E.M. Hauge, MD, PhD, Department of Rheumatology, Aarhus University Hospital, and Department of Clinical Medicine, Aarhus University.
Jazyk:	angličtina
Zdroj:	The Journal of rheumatology [J Rheumatol] 2023 Apr; Vol. 50 (4), pp. 469-477. Date of Electronic Publication: 2022 Nov 15.
DOI:	10.3899/jrheum.220623
Abstrakt:	Objective: To compare in images, obtained by high-resolution peripheral quantitative computed tomography (HR-pQCT) and conventional radiography (CR) of the second and third metacarpophalangeal (MCP) joints, the minimal erosive cortical break needed to differentiate between pathological and physiological cortical breaks. Methods: In this single-center cross-sectional study, patients with established rheumatoid arthritis (disease duration ≥ 5 yrs) had their second and third MCP joints of the dominant hand investigated by HR-pQCT and CR. Empirical estimation was used to find the optimal cut-off value for the number of erosions and total erosive volume, which were detectable between patients with and without erosions in the second and third MCP joints according to CR. Results: The total erosive volume in the second and third MCP joints by HR-pQCT for CR-detected erosive disease was estimated to be 56.4 mm 3 (95% CI 3.5-109.3). The sensitivity and specificity at this cutpoint were 78% and 83%, respectively, with an area under the receiver-operating characteristic curve (AUC) of 0.81. The optimal cut-off value for the number of erosions by HR-pQCT was 8.5 (95% CI 5.9-11.1) for CR-detected erosive disease in the second and third MCP joints. The sensitivity and specificity at this cutpoint were 74% and 88%, respectively, with an AUC of 0.81. Conclusion: Erosions by HR-pQCT were larger in patients with erosive damage in the second and third MCP joints by CR. We found that CR had poor sensitivity for detecting erosive disease when the erosive volume was < 56.4 mm 3 or the number of erosions was < 8.5. (Copyright © 2023 by the Journal of Rheumatology.)
Databáze:	MEDLINE
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