title: Psoriatic arthritis is associated with bone loss of the metacarpals.
abstract: BoneXpert (BX) is a newly developed medical device based on digital X-ray radiogrammetry to measure human cortical bone thickness. The aim of this study was to quantify cortical bone loss of the metacarpals in patients with psoriatic arthritis (PsA) and compare these findings with other radiological scoring methods.
  
  
  
  The study includes 104 patients with verified PsA. The BX method was used to measure the Metacarpal Index (MCI) at the metacarpal bones (II-IV). Additionally, the T-score of the MCI (T-scoreMCI) was calculated. Radiographic severity was determined by the Psoriatic Arthritis Ratingen Score (Proliferation Score and Destruction Score) as published by Wassenberg et al. and the Psoriatic Arthritis modified van der Heijde Sharp Score (Joint Space Narrowing Score and Erosion Score).
  
  
  
  For the total PsA study cohort, the T-scoreMCIwas significantly reduced by -1.289 ± 1.313 SD. The MCI negatively correlated with the Proliferation Score (r = -0.732; p < 0.001) and the Destruction Score (r = -0.771; p < 0.001) of the Psoriatic Arthritis Ratingen Score. Lower coefficients of correlations were observed for the Psoriatic Arthritis modified van der Heijde Sharp Score. In this context, a severity-dependent and PsA-related periarticular demineralisation as measured by the MCI was quantified. The strongest reduction of -30.8 % (p < 0.01) was observed for the MCI in the Destruction Score.
  
  
  
  The BX MCI score showed periarticular demineralisation and severity-dependent bone loss in patients with PsA. The measurements of the BX technique were able to sensitively differentiate between the different stages of disease manifestation affecting bone integrity and thereby seem to achieve the potential to be a surrogate marker of radiographic progression in PsA.
authors: Department of Internal Medicine III, Jena University Hospital-Friedrich Schiller University Jena, Erlanger Allee 101, Jena, 07747, Germany. alexander.pfeil@med.uni-jena.de.
authors: Alexander
authors: A
authors: Pfeil
authors: Department of Internal Medicine III, Jena University Hospital-Friedrich Schiller University Jena, Erlanger Allee 101, Jena, 07747, Germany.
authors: Laura
authors: L
authors: Krojniak
authors: Institute of Diagnostic and Interventional Radiology, Jena University Hospital-Friedrich Schiller University Jena, Erlanger Allee 101, Jena, 07747, Germany.
authors: Diane M
authors: DM
authors: Renz
authors: Department of Internal Medicine III, Jena University Hospital-Friedrich Schiller University Jena, Erlanger Allee 101, Jena, 07747, Germany.
authors: Lisa
authors: L
authors: Reinhardt
authors: Department of Internal Medicine I, Jena University Hospital-Friedrich Schiller University Jena, Erlanger Allee 101, Jena, 07747, Germany.
authors: Marcus
authors: M
authors: Franz
authors: Department of Internal Medicine III, Jena University Hospital-Friedrich Schiller University Jena, Erlanger Allee 101, Jena, 07747, Germany.
authors: Peter
authors: P
authors: Oelzner
authors: Department of Internal Medicine III, Jena University Hospital-Friedrich Schiller University Jena, Erlanger Allee 101, Jena, 07747, Germany.
authors: Gunter
authors: G
authors: Wolf
authors: Institute of Diagnostic and Interventional Radiology, SRH Wald-Klinikum Gera, Straße des Friedens 122, Gera, 07548, Germany.
authors: Joachim
authors: J
authors: Böttcher
mesh_terms: D000328:Adult; D000368:Aged; D015535:Arthritis, Psoriatic / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D050279:Metacarpal Bones / Q000000981:diagnostic imaging* / Q000473:pathology; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000379:methods*
keywords: Bone mineral density; BoneXpert; Cortical bone loss; Digital X-ray radiogrammetry; Periarticular demineralisation; Psoriatic arthritis