• Z Rheumatol · Dec 2004

    Comparative Study

    [Clinical trial for differentiation between corticoid-induced osteoporosis and periarticular demineralization via digital radiogrammetry in patients suffering from rheumatoid arthritis].

    • J Böttcher, A Pfeil, G Lehmann, B Heinrich, A Malich, A Hansch, A Petrovitch, H-J Mentzel, G Hein, and W A Kaiser.
    • Institut für Diagnostische und Interventionelle Radiologie, Friedrich-Schiller-Universität Jena, Erlanger Allee 101, 07747 Jena, Germany. joachim.boettcher@med.uni-jena.de
    • Z Rheumatol. 2004 Dec 1;63(6):473-82.

    PurposeTo investigate a new bone densitometric technology based on digital radiogrammetry (DXR) with respect to its ability to measure severity-dependent variations of bone mineral density (BMD) in patients with rheumatoid arthritis and to differentiate between corticoid-induced and periarticular bone mineral density loss.Patients And MethodsA total of 153 randomly selected patients suffering from verified rheumatoid arthritis underwent digitally performed plain radiographs of the non-dominant hand and also measurements of dual-energy X-ray absorptiometry (DXA) regarding total femur and lumbar spine in 102 patients and peripheral quantitative computed tomography (pQCT) regarding the distal radius in 51 patients. Using DXR the radiographs of the non-dominant hand were analyzed for cortical bone mineral density calculation. The severity was classified in the DXA group using the Ratingen score. Furthermore, both study populations were divided into patients with and without corticoid therapy.ResultsCorrelations between BMD determined by DXR and by DXA (R=0.44 for lumbar spine and R=0.61 for total femur) versus pQCT (0.46ConclusionThe DXR-based BMD calculation can distinguish severity and progress of disease-related periarticular demineralization in contrast to those of DXA. In this context, DXA primarily measures the systemic (corticoid-induced) osteoporosis and pQCT partially estimates disease-related bone mineral density loss, whereas DXR can predominantly analyze and quantify the periarticular demineralization, which often shows a manifestation at an early stage of rheumatoid arthritis. Therefore DXR seems to be a diagnostic tool in the course of rheumatoid arthritis.

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