title: Assessment of hand trabecular bone texture with high resolution direct digital radiograph in rheumatoid arthritis: a case control study.
abstract: OBJECTIVE
  Rheumatoid arthritis is characterized by an early inflammatory related periarticular osteopenia. A new high resolution direct digital X-ray device has been recently developed to provide bone texture analysis which is designed to assess changes in trabecular bone architecture. For the first time, we have evaluated trabecular bone texture impairment in rheumatoid arthritis patients compared to healthy controls.
  
  
  METHODS
  In this cross-sectional study, the reproducibility was assessed by three separate digital X-rays of the right hand, with repositioning in 14 late rheumatoid arthritis patients and 14 healthy subjects. Then, trabecular bone texture of the MCP2 and MCP3 from patients enrolled in a prospective cohort of 78 rheumatoid arthritis patients was compared with that of 50 healthy subjects, using three texture parameters: Hmean, co-occurrence and run-length.
  
  
  RESULTS
  The coefficients of variation of the high resolution direct digital X-ray measurements ranged from 0.5 to 1.8%. Only the Hmean parameter was significantly decreased in rheumatoid arthritis patients compared to healthy subjects at MCP2 (0.637±0.040 vs. 0.654±0.032, P<0.05) and at MCP3 (0.646±0.044 vs. 0.665±0.037, P<0.05). This reduction was significantly correlated to disease activity.
  
  
  CONCLUSIONS
  This study demonstrated both the good reproducibility of the high resolution digital X-ray measurements and the trabecular bone texture impairment at MCP joints in rheumatoid arthritis patients. In addition to provide a high resolution hand radiograph, this technique may represent an interesting tool to easily quantify periarticular osteopenia with a low radiation dose.
authors.affiliation: Service de rhumatologie, Inserm U1033, université de Lyon, hôpital Edouard-Herriot, 5, place d'Arsonval, 69437 Lyon, France. anne.fouque-aubert@chu-lyon.fr
authors.forename: Anne
authors.initials: A
authors.lastname: Fouque-Aubert
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Boutroy
authors.forename: Hubert
authors.initials: H
authors.lastname: Marotte
authors.forename: Nicolas
authors.initials: N
authors.lastname: Vilayphiou
authors.forename: Eric
authors.initials: E
authors.lastname: Lespessailles
authors.forename: Claude-Laurent
authors.initials: CL
authors.lastname: Benhamou
authors.forename: Pierre
authors.initials: P
authors.lastname: Miossec
authors.forename: Roland
authors.initials: R
authors.lastname: Chapurlat
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000000981:diagnostic imaging*; D001851:Bone Diseases, Metabolic / Q000000981:diagnostic imaging* / Q000209:etiology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D050279:Metacarpal Bones / Q000000981:diagnostic imaging*; D008875:Middle Aged; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed; D055815:Young Adult