Longitudinal changes of metacarpal cortical striation in Graves' disease.
OBJECTIVE
The authors verify whether metacarpal cortical striation can be used to assess longitudinal changes in bone turnover in Graves' disease.


METHODS
Eight patients with untreated Graves' disease (5 men, 3 women; age 36 +/- 12 years) and six patients with the disease in remission (1 man, 5 women; age 38 +/- 12) were studied. Posteroanterior radiographs of the bilateral hands were obtained using fine-grain mammography film and direct magnification. Three observers independently determined the grade of cortical striation (striation index; SI) of the second and third metacarpals in randomly presented radiographs.


RESULTS
The SI determined by all observers decreased significantly after the beginning of antihyperthyroid therapy compared with the SI before treatment (P < 0.05). Significant correlation was found between the observers' assessments (r = 0.74, P < 0.001). The average kappa value and percent agreement were 0.27 and 51.8%, respectively. Intraobserver variability provided relatively good kappa statistics (kappa: 0.56; percent agreement: 79.9%). Longitudinal decrease in the SI was in accordance with a decline in urinary pyridinoline cross-link excretion, a decline in serum osteocalcin, and an increase in bone mineral density of lumbar spine.


CONCLUSIONS
The change in the SI can be used to detect increased and decreased bone turnover. Thus, the SI can be used as one index of bone turnover in patients with Graves' disease.
Sugimoto
H
H
Department of Radiology, Jichi Medical School, Tochigi-ken, Japan. hideharu@jichi.ac.jp
Nagasaka
S
S
Hyodoh
K
K
Sakai
O
O
Kamiyama
T
T
Furuse
M
M
D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D000596:Amino Acids / Q000652:urine; D015415:Biomarkers; D015519:Bone Density; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006111:Graves Disease / Q000097:blood / Q000000981:diagnostic imaging* / Q000652:urine; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000378:metabolism; D008297:Male; D008663:Metacarpus / Q000000981:diagnostic imaging* / Q000378:metabolism; D008875:Middle Aged; D015588:Observer Variation; D015675:Osteocalcin / Q000097:blood; D011856:Radiographic Image Enhancement; D015203:Reproducibility of Results
D000596:Amino Acids; D015415:Biomarkers; D015675:Osteocalcin; C015484:pyridinoline