Measuring metacarpal cortical bone by digital x-ray radiogrammetry: a step forward?
1 Department of Internal Medicine, Subdivision of Rheumatology, Maastricht University Medical Centre, P. Debyelaan 25, Postbus 5800, 6202 AZ Maastricht, The Netherlands
2 Biomedical Research Institute, Hasselt University, Agoralaan, gebouw D B-3590 Diepenbeek, Belgium
3 Department of Rheumatology, Vrije Universiteit Medical Centre, 3A64, Postbus 7057, 1007 MB Amsterdam, The Netherlands
Arthritis Research & Therapy 2009, 11:127 doi:10.1186/ar2788
See related research by Bøyesen et al., http://arthritis-research.com/content/11/4/R103Published: 1 October 2009
Changes in metacarpal cortical bone mineral density (BMD) using digital x-ray radiogrammetry were studied in patients with early rheumatoid arthritis. After 1, 2, and 5 years, large BMD losses were found: -1.7%, -2.8%, and -5.6%, respectively. Elevated erythrocyte sedimentation rate and anti-cyclic citrullinated peptide levels were independent predictors of bone loss, indicating that the largest amount of bone loss was found in patients with severe inflammation and high production of auto-antibodies, who are known to be at the highest risk of developing radiological bone damage. Studies are needed about the spatial and time relationship between erosions and juxta-articular and metacarpal bone loss.