RESEARCH - A comparative study of periarticular bone lesions in RA and psoriatic arthritis

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Ann Rheum Dis. 2010 Oct 11. [Epub ahead of print]

A comparative study of periarticular bone lesions in rheumatoid

arthritis and psoriatic arthritis.

Finzel S, Englbrecht M, Engelke K, Stach C, Schett G.

1Department of Internal Medicine 3 and Institute for Clinical

Immunology, University of Erlangen-Nuremberg, Erlangen, Germany.

Abstract

BACKGROUND: Psoriatic arthritis (PsA) and rheumatoid arthritis (RA)

are both destructive arthritides but may differ substantially in their

periarticular bone changes.

OBJECTIVES: To investigate the differences in the structural changes

of periarticular bone in patients with PsA and RA by a high-resolution

imaging technique designed to visualise the bone architecture.

METHODS: 30 patients with PsA and 58 patients with RA received a µCT

scan to compare structural bone changes in the metacarpophalangeal

joints of the dominantly affected hand. Number, extent, form and

distribution of bone erosions, osteophytes and cortical thinning were

recorded. In addition, the size and depth of bone erosions and the

size of osteophytes were determined.

RESULTS: Patients with PsA and RA had the same number of bone

erosions, but they were less severe and overall smaller in size and

depth in PsA. Erosions in PsA were mostly Ω-shaped and tubule-shaped,

whereas U-shaped lesions were most typical for RA. Erosions in PsA

were more evenly distributed, lacking the strong preponderance for the

radial sites found in RA. Osteophytes were increased in number, extent

and size in PsA as compared with RA, often affecting the entire

circumference of bone ('bony corona').

CONCLUSIONS: High-resolution µCT imaging shows profound differences in

periarticular bone changes between PsA and RA. Smaller Ω-shaped and

tubule-shaped bone erosions as well as large sometimes corona-shaped

osteophytes are typical for PsA. These data suggest that mechanisms of

bone repair may be more active in PsA than in RA.

PMID: 20937672

http://www.ncbi.nlm.nih.gov/pubmed/20937672

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