Structural and Microstructural Intraarticular Bone Changes at the Metacarpal Heads in Patients with Psoriatic Arthritis Compared to Controls: A HR-pQCT Study

Dongze Wu¹, James F Griffith², Steven H.M. Lam¹, Jiang Yue¹, Priscilla Wong¹, Lin Shi³, Edmund Li¹, Isaac T. Cheng¹, Tena K. Li¹, Tracy Y. Zhu⁴, Vivian W. Hung⁴, Ling Qin⁵ and Lai-Shan Tam⁶, ¹Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China, Hong Kong, China, ²Department of Imaging and Interventional Radiology, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China, ³Research Centre for Medical Image Computing, Department of Imaging and Interventional Radiology, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China, ⁴Bone Quality and Health Centre of the Department of Orthopedics & Traumatology, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China, ⁵Bone Quality and Health Centre of the Department of Orthopedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong, ⁶Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Bone, bone density and psoriatic arthritis, Imaging

Session Information

Date: Sunday, October 21, 2018

Title: 3S082 ACR Abstract: Imaging of Rheumatic Diseases I: MRI & CT (863–868)

Session Type: ACR Concurrent Abstract Session

Session Time: 2:30PM-4:00PM

Background/Purpose:

Metacarpal head directly exposed to intra-articular inflammatory milieu, therefore may lead to abnormal bone remodeling (bone loss and new bone formation).

The aims of this study are to investigate the structural (bone erosion and enthesiophyte) and microstructural bone changes in patients with PsA at the second and third metacarpal head (MCH2&3) compared with controls.

Methods:

139 subjects (77 PsA, 62 control) underwent high-resolution peripheral quantitative computed tomography (HR-pQCT) scanning at the MCH 2 and 3 and distal radius. Structural and microstructural bone changes at the MCH 2 and 3 were calculated (Figure 1) and compared between PsA patients and healthy controls.

Results:

15 patients with joint destruction were excluded from further analysis. 62 patients with PsA and controls were comparable in age, gender and body mass index (BMI). PsA patients had a significantly increased number (2.4±1.4 vs 1.3±1.1, p<0.001) and total enthesiophytes volume per person (8.75±6.92 vs 4.36±4.90 mm³, p<0.001) compared to controls. Erosion number (2.9±1.2 vs 2.7±1.4, p=0.408) and total erosion volume per person (11.88±7.82 vs 9.64±5.96 mm³, p=0.076) were similar in PsA patients compared with control. Regarding microstructure, PsA patients had a significantly decreased total volumetric bone mineral density (vBMD), cortical vBMD and cortical thickness at the distal radius; while a preferential bone loss at the trabecular compartment at the MCH was noticed compared to control. Regression model in PsA showed that advancing age, a higher BMI and C-reactive protein level were independent explanatory variables associated with a larger erosion volume. In contrast, older age and swollen joint count were independent explanatory variable associated with an increase in enthesiohyte volume.

Conclusion:

Intra-articular trabecular bone loss and entheseal new bone formation was more prevalent in the MCH of patients with PsA.

Disclosures: This study has been partly presented at EULAR2018.

Disclosure: D. Wu, None; J. F. Griffith, None; S. H. M. Lam, None; J. Yue, None; P. Wong, None; L. Shi, None; E. Li, None; I. T. Cheng, None; T. K. Li, None; T. Y. Zhu, None; V. W. Hung, None; L. Qin, None; L. S. Tam, None.

To cite this abstract in AMA style:

Wu D, Griffith JF, Lam SHM, Yue J, Wong P, Shi L, Li E, Cheng IT, Li TK, Zhu TY, Hung VW, Qin L, Tam LS. Structural and Microstructural Intraarticular Bone Changes at the Metacarpal Heads in Patients with Psoriatic Arthritis Compared to Controls: A HR-pQCT Study [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/structural-and-microstructural-intraarticular-bone-changes-at-the-metacarpal-heads-in-patients-with-psoriatic-arthritis-compared-to-controls-a-hr-pqct-study/. Accessed .

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