Background New sensitive imaging techniques may detect longitudinal improvements in bone quality with treatment in early inflammatory arthritis.
Objectives Quantify measures of bone damage in the first year of rheumatoid arthritis (RA) and undifferentiated arthritis (UA) by high-resolution peripheral quantitative computed tomography (HR-pQCT, Scanco Medical AG, Switzerland), which provides bone microarchitecture resolution at 82 μm.
Methods HR-pQCT images of the 2nd and 3rd MCP joints of subjects at diagnosis and controls were obtained, with repeat scans at 1 year. The manufacturer’s standard evaluation protocol was applied to quantify measures of bone density and microarchitecture. Joint space width was measured using a custom analysis implemented for the HR-pQCT based on direct measurements from the high resolution image data.
Results Twenty-one subjects with inflammatory disease (RA=17, UA=4) and three controls have been scanned. These subjects are 71% female, mean 45 years of age, mean symptom duration at diagnosis 6.5 months, BMI 28.6, 41% are RF positive and 67% anti-CCP positive. The mean reduction at 1 year for clinical parameters was: tender joint counts 11.3 (SD 8.3)/28, swollen joint count 9.7 (SD 6.9)/28, HAQ 0.68 (SD 0.82) and DAS28 2.93 (SD 2.13).
Conclusions Treatment initiation in early inflammatory arthritis results in stabilization of bone density and no joint space narrowing was observed. Bone density was lower in patients with inflammatory disease and did not improve with treatment despite improvement in clinical disease activity measures.
Disclosure of Interest None Declared