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Extended report
Assessment of hand bone loss in rheumatoid arthritis by high-resolution peripheral quantitative CT
  1. Anne Fouque-Aubert1,
  2. Stéphanie Boutroy1,
  3. Hubert Marotte2,
  4. Nicolas Vilayphiou1,
  5. Justine Bacchetta1,
  6. Pierre Miossec2,
  7. Pierre Dominique Delmas1,
  8. Roland D Chapurlat1
  1. 1Inserm U831, Université de Lyon, Service de Rhumatologie, Hôpital Edouard Herriot, Lyon, France
  2. 2Université de Lyon, Service de Rhumatologie, Hôpital Edouard Herriot, Lyon, France
  1. Correspondence to Dr Anne Fouque-Aubert, Inserm U831, Université de Lyon, Service de Rhumatologie, Hôpital Edouard Herriot, 5 Place d'Arsonval, 69437 Lyon, France; afamedezine{at}


Objectives A new high-resolution peripheral quantitative CT (HR-pQCT) system allows for in vivo assessment of bone microarchitecture and volumetric bone mineral density (vBMD) with an 82 µm isotropic resolution. With this device, the microarchitecture impairment was evaluated in patients with rheumatoid arthritis (RA) in comparison with healthy controls and measured the erosion volume at metacarpal heads (MCPs).

Methods In this cross-sectional study, the reproducibility was first assessed by 3 HR-pQCT exams with repositioning in 14 patients with late RA and 14 healthy subjects. Then, HR-pQCT parameters were measured in a group of 93 patients with RA and 31 healthy controls. Two RA subgroups were distinguished: early RA (disease duration ≤2 years) (n=36) and late RA (n=57) and compared them to healthy controls.

Results The precision of the HR-pQCT volumetric measurements as assessed with coefficient of variation ranged from 0.7% to 1.8% in patients with late RA and from 0.6% to 1.4% in healthy subjects at MCPs. Total and trabecular vBMD and trabecular thickness were significantly decreased in patients with RA compared to healthy subjects and were significantly correlated to disease activity. The erosion volume was highly correlated to a semiquantitative assessment using the Outcome Measures in Rheumatoid Arthritis Clinical Trials (OMERACT) scoring system applied to the HR-pQCT slices.

Conclusions This study demonstrated the good reproducibility of the HR-pQCT volumetric measurements at MCPs and confirmed the involvement of trabecular compartment in periarticular osteopoenia. Thus, HR-pQCT appears interesting to simultaneously assess differences in bone volumetric density, microarchitecture and erosions.

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  • Ethics approval This study was conducted with the approval of the CPP sudest II.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent Obtained.

  • Competing interests None declared.