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Impaired bone microarchitecture in distal interphalangeal joints in patients with primary hypertrophic osteoarthropathy assessed by high-resolution peripheral quantitative computed tomography

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Abstract

Summary

This study aimed to investigate the bone impairment in finger joints in PHO patients by HR-pQCT. Results showed distinguished differences in bone architecture and biomechanics parameters at DIPs between PHO patients and healthy controls using HR-pQCT assessment. Besides, serum PGE2, hsCRP and ESR levels were found negatively correlated with total vBMD.

Introduction

This study aimed to investigate the bone impairment in finger joints in primary hypertrophic osteoarthropathy (PHO) patients firstly by high-resolution peripheral quantitative computed tomography (HR-pQCT).

Methods

Fifteen PHO patients and 15 healthy controls were enrolled in this study. Bone erosions in hands at distal interphalangeal joints (DIPs) in both PHO patients and controls were evaluated by X-ray. Bone geometry, vBMD, microstructure parameters, and size of individual bone erosion were also measured at the 3rd DIP by HR-pQCT as well. Blood biochemistry levels between the two groups were also compared.

Results

Compared to X-ray, HR-pQCT assessment were more sensitive for detection of bone erosions, with 14 PHO patients by HR-pQCT versus ten PHO patients by X-ray judged at the 3rd DIP. The average depth, width, and volume of erosions size in PHO patients were 1.38 ± 0.80 mm, 0.79 ± 0.27 mm, and 1.71 ± 0.52 mm3, respectively. The bone cross-areas including total area (+ 25.3%, p ≤ 0.05), trabecular area (+ 56.2%, p ≤ 0.05), and cortical perimeter (+ 10.7%, p ≤ 0.05) at the defined region of interest of 3rd DIP was significantly larger than controls. Total vBMD was 11.9% lower in PHO patients compared with the controls (p ≤ 0.05). Biochemical test results showed the increased levels of inflammatory cytokines, bone resorption markers, and joint degeneration markers in PHO patients. Serum prostaglandin PGE2, high-sensitive C-reactive protein (hsCRP) and erythrocyte sedimentation rate (ESR) levels were found negatively correlated with total vBMD.

Conclusions

This study demonstrated higher sensitivity of the HR-pQCT measurement at DIPs by showing the differences in architecture and biomechanics parameters at DIPs between the PHO patients and healthy controls, which would be of interest clinically to investigate bone deterioration in PHO patients.

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Acknowledgments

We would like to give the sincere thanks to the subjects for consenting to participate in this study.

Funding

This study was supported by the National Natural Science Foundation of China (No.81471088 and No. 81670714) and Bone Quality and Health Assessment Center of the Department of Orthopaedics and Traumatology, the Chinese University of Hong Kong for providing hand fixator for HR-pQCT scanning.

Author information

Authors and Affiliations

  1. Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan No.1, Dongcheng District, Beijing, 100730, China

    Q. Pang, Y. Xu, X. Qi, R. Liao, Y. Hou, Y. Jiang, O. Wang, M. Li, X. Xing & W. Xia

  2. Musculoskeletal Research Laboratory and Bone Quality and Health Assessment Centre, Department of Orthopedics & Traumatology, The Chinese University of Hong Kong, 5/F Lui Che Woo Clinical Sciences Building, Prince of Wales Hospital, Shatin, N.T., Hong Kong, SAR, Hong Kong

    Q. Pang, L. Huang, V.W. Hung, J. Xu & L. Qin

  3. Department of Endocrinology, The First Affiliated Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, China

    Y. Xu

  4. Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China

    W. Yu

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  1. Q. Pang
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  2. Y. Xu
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  3. X. Qi
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  4. L. Huang
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  15. L. Qin
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Contributions

Prof. Ling Qin and Prof. Weibo Xia were responsible for study design. Ms. Qianqian Pang performed the study and prepared the first draft of the paper. Ms. Qianqian Pang, Dr. Ruoxi Liao, Ms. Yuping Xu, Ms. Yanfang Hou, and Dr. Jiankun Xu contributed to the clinical and experimental work. Dr. Vivian W Hung, Dr. Xuan Qi, and Ms. Qianqian Pang contributed to the imaging analyses. Ms. Qianqian Pang, Dr. Xuan Qi, and Dr. Le Huang were responsible for statistical analysis of the data. All of the authors contributed to revise the paper critically for intellectual content and approved the final version of the submitted manuscript.

Corresponding authors

Correspondence to W. Xia or L. Qin.

Ethics declarations

All subjects signed informed consent for imaging measures as well as blood sample collections. This study was approved by the Ethics Committee of PUMCH with the ethics audit number zs-1115.

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Pang, Q., Xu, Y., Qi, X. et al. Impaired bone microarchitecture in distal interphalangeal joints in patients with primary hypertrophic osteoarthropathy assessed by high-resolution peripheral quantitative computed tomography. Osteoporos Int 31, 153–164 (2020). https://doi.org/10.1007/s00198-019-05168-3

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