Impaired bone microarchitecture in distal interphalangeal joints in patients with primary hypertrophic osteoarthropathy assessed by high-resolution peripheral quantitative computed tomography

Pang, Q.<sup>1,2</sup>; Xu, Y.<sup>1,3</sup>; Qi, X.<sup>1</sup>; Huang, L.<sup>2</sup>; Hung, V. W.<sup>2</sup>; Xu, J.<sup>2</sup>; Liao, R.<sup>1</sup>; Hou, Y.<sup>1</sup>; Jiang, Y.<sup>1</sup>; Yu, W.<sup>4</sup>; Wang, O.<sup>1</sup>; Li, M.<sup>1</sup>; Xing, X.<sup>1</sup>; Xia, W.<sup>1</sup>; Qin, L.<sup>2</sup>

Affiliations

¹Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China

²Musculoskeletal Research Laboratory and Bone Quality and Health Assessment Centre, Department of Orthopedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong

³Department of Endocrinology, The First Affiliated Hospital of Shanxi Medical University, Taiyuan, China

⁴Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China

Abstract and keywords

Summary: This study aimed to investigate the bone impairment in finger joints in PHO patients by HR-pQCT. Results showed distinguished differences in bone architecture and biomechanics parameters at DIPs between PHO patients and healthy controls using HR-pQCT assessment. Besides, serum PGE2, hsCRP and ESR levels were found negatively correlated with total vBMD.

Introduction: This study aimed to investigate the bone impairment in finger joints in primary hypertrophic osteoarthropathy (PHO) patients firstly by high-resolution peripheral quantitative computed tomography (HR-pQCT).

Methods: Fifteen PHO patients and 15 healthy controls were enrolled in this study. Bone erosions in hands at distal interphalangeal joints (DIPs) in both PHO patients and controls were evaluated by X-ray. Bone geometry, vBMD, microstructure parameters, and size of individual bone erosion were also measured at the 3rd DIP by HR-pQCT as well. Blood biochemistry levels between the two groups were also compared.

Results: Compared to X-ray, HR-pQCT assessment were more sensitive for detection of bone erosions, with 14 PHO patients by HR-pQCT versus ten PHO patients by X-ray judged at the 3rd DIP. The average depth, width, and volume of erosions size in PHO patients were 1.38 ± 0.80 mm, 0.79 ± 0.27 mm, and 1.71 ± 0.52 mm3, respectively. The bone cross-areas including total area (+ 25.3%, p ≤ 0.05), trabecular area (+ 56.2%, p ≤ 0.05), and cortical perimeter (+ 10.7%, p ≤ 0.05) at the defined region of interest of 3rd DIP was significantly larger than controls. Total vBMD was 11.9% lower in PHO patients compared with the controls (p ≤ 0.05). Biochemical test results showed the increased levels of inflammatory cytokines, bone resorption markers, and joint degeneration markers in PHO patients. Serum prostaglandin PGE2, high-sensitive C-reactive protein (hsCRP) and erythrocyte sedimentation rate (ESR) levels were found negatively correlated with total vBMD.

Conclusions: This study demonstrated higher sensitivity of the HR-pQCT measurement at DIPs by showing the differences in architecture and biomechanics parameters at DIPs between the PHO patients and healthy controls, which would be of interest clinically to investigate bone deterioration in PHO patients.

Keywords: Distal interphalangeal joints; HR-pQCT; Primary hypertrophic osteoarthropathy; Prostaglandin PGE2

Links

DOI: 10.1007/s00198-019-05168-3

PubMed: 31646353

WoS: 000492023300003

History

Received: 2019-03-13

Accepted: 2019-09-12

Online: 2019-10-23

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Cited By (1)

Year	Entry
2022	Pang Q, Xu Y, Huang L, Li Y, Lin Y, Hou Y, Hung VW, Qi X, Ni X, Li M, Jiang Y, Wang O, Xing X, Qin L, Xia W. Bone geometry, density, microstructure, and biomechanical properties in the distal tibia in patients with primary hypertrophic osteoarthropathy assessed by second-generation high-resolution peripheral quantitative computed tomography. J Bone Miner Res. March 2022;37(3):484-493.