Minimal Erosive Volume Needed for Radiographic Identification of Erosions in the Metacarpophalangeal Joints in Rheumatoid Arthritis. a Comparative Analysis of High Resolution Peripheral Quantitative Computed Tomography and Conventional Radiography

Rasmus Klose-Jensen, Josephine Therkildsen, Anne-Birgitte Garm Blavnsfeldt, Bente L. Langdahl, Anna Zejden, Jesper Thygensen, Kresten Krarup Keller and Ellen-Margrethe Hauge, Aarhus University Hospital, Aarhus, Denmark

Meeting: ACR Convergence 2021

Keywords: Computed tomography (CT), Erosions, radiography, rheumatoid arthritis

Session Information

Date: Tuesday, November 9, 2021

Session Title: RA – Diagnosis, Manifestations, & Outcomes Poster IV: Outcomes, Trajectory of Disease, & Epidemiology (1645–1673)

Session Type: Poster Session D

Session Time: 8:30AM-10:30AM

Background/Purpose: The purpose of this study was to estimate the minimal erosive volume identified by High-Resolution peripheral Quantitative Computed Tomography (HR-pQCT) needed in order to identify erosive damage by conventional radiography (CR) assessed by the Sharp/van der Heijde method in patients with rheumatoid arthritis (RA).

Methods: In this single-centre cross-sectional study with paired measurements, 353 patients with established RA (disease duration ≥ five years) 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 cutoff value for the number, and the total volume of erosions needed to be identified by CR assessed according to the Sharp/van der Heijde method.

Results: The second and third MCP joints from 353 patients were investigated. Erosive damage was identified in 157 of the 706 MCP joints by CR, whereas 464 of the 706 MCP joints had erosive damage by HR-pQCT. Patients with a total erosive volume in the second and third MCP joints by HR-pQCT below 48.9 mm3 (Sensitivity 79%, Specificity 0.85, area under the receiver operating characteristic curve (AUC) 0.82) were not consistently identified by CR. The empirical estimation of the optimal cutoff value for the number of erosions in the second and third MCP joints by HR-pQCT was 8.5 erosions (Sensitivity 73%, Specificity 0.90, AUC 0.81).

Conclusion: Conventional radiography could not consistently identify erosive damage in the second and third MCP joints in patients with a total erosive volume below approximately 48.9 mm3 and missed two-thirds of erosions identified by HR-pQCT; this suggests that HR-pQCT may be a valuable tool for earlier detection of erosion progression in RA allowing for earlier intervention.

Disclosures: R. Klose-Jensen, Novo Nordic Foundation, 5, Aarhus University, 5, The Danish Rheumatism Association, 5, A.P. Møller Fonden, 5; J. Therkildsen, None; A. Garm Blavnsfeldt, None; B. L. Langdahl, Eli Lilly, 6, Amgen, 6, UCB, 6, Gilead, 6, Gideon-Richter, 6, Novo Nordisk, 5, Amgen, 5; A. Zejden, None; J. Thygensen, None; K. Keller, None; E. Hauge, AbbVie, 6, Sanofi, 6, Sobi, 6, SynACT Pharma, 6, Novo Nordic Foundation, 5, Roche, 5, Novartis, 5.

To cite this abstract in AMA style:

Klose-Jensen R, Therkildsen J, Garm Blavnsfeldt A, L. Langdahl B, Zejden A, Thygensen J, Keller K, Hauge E. Minimal Erosive Volume Needed for Radiographic Identification of Erosions in the Metacarpophalangeal Joints in Rheumatoid Arthritis. a Comparative Analysis of High Resolution Peripheral Quantitative Computed Tomography and Conventional Radiography [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/minimal-erosive-volume-needed-for-radiographic-identification-of-erosions-in-the-metacarpophalangeal-joints-in-rheumatoid-arthritis-a-comparative-analysis-of-high-resolution-peripheral-quantitative-c/. Accessed March 28, 2023.

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