Article

Journal of Digital Imaging

, Volume 19, Issue 3, pp 279-288

Computerized Digital Imaging Techniques Provided by Digital X-ray Radiogrammetry as New Diagnostic Tool in Rheumatoid Arthritis

  • Joachim BöttcherAffiliated withInstitute of Diagnostic and Interventional Radiology, Friedrich-Schiller University Jena Email author 
  • , Alexander PfeilAffiliated withInstitute of Diagnostic and Interventional Radiology, Friedrich-Schiller University Jena
  • , Anders RosholmAffiliated withSectra Pronosco A/S
  • , Max-Ludwig SchäferAffiliated withInstitute of Diagnostic and Interventional Radiology, Friedrich-Schiller University Jena
  • , Ansgar MalichAffiliated withInstitute of Diagnostic and Interventional Radiology, Friedrich-Schiller University Jena
  • , Alexander PetrovitchAffiliated withInstitute of Diagnostic and Interventional Radiology, Friedrich-Schiller University Jena
  • , Bettina SeidlAffiliated withInstitute of Diagnostic and Interventional Radiology, Friedrich-Schiller University Jena
  • , Gabriele LehmannAffiliated withClinic of Internal Medicine III, Friedrich-Schiller University Jena
  • , Hans-Joachim MentzelAffiliated withInstitute of Diagnostic and Interventional Radiology, Friedrich-Schiller University Jena
    • , Gert HeinAffiliated withClinic of Internal Medicine III, Friedrich-Schiller University Jena
    • , Gunter WolfAffiliated withClinic of Internal Medicine III, Friedrich-Schiller University Jena
    • , Werner A. KaiserAffiliated withInstitute of Diagnostic and Interventional Radiology, Friedrich-Schiller University Jena

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Purpose

Our study evaluates digital x-ray radiogrammetry (DXR) and Radiogrammetry Kit (RK) as a new diagnostic method for the measurement of disease-related osteoporosis including quantification of joint space narrowing dependent on the severity of rheumatoid arthritis (RA).

Materials and Methods

A total of 172 unselected patients with RA underwent computerized measurements of bone mineral density (BMD) and metacarpal index (MCI) by DXR, as well as a semiautomated measurement of joint space distances at the metacarpal–phalangeal articulation (JSD-MCP 2–5), both were analyzed from plain radiographs of the nondominant hand.

Results

Correlations between DXR-BMD and DXR-MCI vs. parameters of RK were all significant (0.34 < R < 0.61; p < 0.01). An expected negative association was observed between RK parameters and the different scoring methods (−0.27 < R < −0.59). The maximum relative decrease in BMD vs. MCI as measured by DXR between the highest and lowest RA severity group was −27.7% vs. −27.5% (p < 0.01) for the modified Larsen Score, whereas the minimal value of relative DXR-BMD and DXR-MCI reduction could be documented for the Sharp Erosion Score (−20.8% vs. −26.8%; p < 0.01). The relative reduction of mean JSD-MCP using RK significantly varied from −25.0% (Sharp Erosion Score) to −41.2% (modified Larsen Score). In addition, an excellent reproducibility of DXR and RK could be verified.

Conclusion

DXR in combination with RK could be a promising, widely available diagnostic tool to supplement the different scoring methods of RA with quantitative data, allowing an earlier and improved diagnosis and more precision in determining disease progression.

Key Words

Digital x-ray radiogrammetry rheumatoid arthritis joint space width bone mineral density metacarpal index Larsen Score Sharp Score