title: Prospective assessment of bone texture parameters at the hand in rheumatoid arthritis.
abstract: OBJECTIVE
  Fractal bone analysis (Hmean) is a texture parameter reflecting bone microarchitecture. The BMA device (D3A™ Medical Systems, Orléans, France) is a high-resolution X-ray device that allows assessment of bone texture analysis. We aimed to measure Hmean in rheumatoid arthritis patients at the second and third metacarpal bones, at baseline and after 1 year of follow-up, and to assess the relationship of Hmean and rheumatoid arthritis disease parameters.
  
  
  METHODS
  Patients with rheumatoid arthritis according to ACR criteria were included. They were assessed over 1 year, in the context of a prospective study conducted in Maastricht. For this substudy, activity of the disease was assessed by erythrocyte sedimentation rate, C-reactive protein and Disease Activity Score 28 performed at each visit. Radiographic bone damage was assessed using hand and feet radiographs at baseline and on a 1-year basis. The bone texture parameters were evaluated on the second and third metacarpal heads of the left hand using BMA device.
  
  
  RESULTS
  One hundred and sixty-five rheumatoid arthritis patients were included in this study. At baseline, Hmean was negatively correlated with age [r=-0.22 (P=0.013)] and erythrocyte sedimentation rate [r=-0.16 (P=0.039)]. No significant correlation was found between Hmean and Disease Activity Score, disease activity Visual Analog Scale, daily corticosteroid dose and C-reactive protein. There was a significant increase in Hmean of second and third metacarpal bones over 1 year (1.6% and 1.3%, P<0.01) except in patients with local second and third metacarpal bones erosion.
  
  
  CONCLUSIONS
  The bone texture parameter Hmean is influenced by age, inflammation and local erosions in rheumatoid arthritis.
authors: Paris Descartes University, Rheumatology department, Cochin Hospital, Paris, France. Electronic address: sparsal@ch-mulhouse.fr.
authors: Laetitia
authors: L
authors: Sparsa
authors: Sami
authors: S
authors: Kolta
authors: Karine
authors: K
authors: Briot
authors: Simon
authors: S
authors: Paternotte
authors: Rasha
authors: R
authors: Masri
authors: Damien
authors: D
authors: Loeuille
authors: Piet
authors: P
authors: Geusens
authors: Christian
authors: C
authors: Roux
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging*; D005260:Female; D006225:Hand / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D050279:Metacarpal Bones / Q000000981:diagnostic imaging*; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography
keywords: BMA; Metacarpal bone; Microarchitecture; Rheumatoid arthritis; Texture analysis