Skip to main content
Top
Published in: Journal of Digital Imaging 3/2006

01-09-2006

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

Authors: Joachim Böttcher, M.D., Alexander Pfeil, Anders Rosholm, Ph.D., Max-Ludwig Schäfer, Ansgar Malich, M.D., Alexander Petrovitch, M.D., Bettina Seidl, Gabriele Lehmann, M.D., Hans-Joachim Mentzel, M.D., Gert Hein, M.D., Gunter Wolf, M.D., Werner A. Kaiser, M.D., M.S.

Published in: Journal of Imaging Informatics in Medicine | Issue 3/2006

Login to get access

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.
Literature
1.
go back to reference Blair, WF 1996An approach to complex rheumatoid arthritis hand and wrist problemsHand Clin12615628PubMed Blair, WF 1996An approach to complex rheumatoid arthritis hand and wrist problemsHand Clin12615628PubMed
2.
go back to reference Sugimoto, H, Takeda, A, Masuyama, J, Furuse, M 1996Early-stage rheumatoid arthritis diagnositic accuracy of MR imagingRadiology198185192PubMed Sugimoto, H, Takeda, A, Masuyama, J, Furuse, M 1996Early-stage rheumatoid arthritis diagnositic accuracy of MR imagingRadiology198185192PubMed
3.
go back to reference Tak, PP, Bresnihan, B 2000The pathogenesis and prevention of joint damage in rheumatoid arthritis. Advances from synovial biopsy and tissue analysisArthritis Rheum4326192633PubMedCrossRef Tak, PP, Bresnihan, B 2000The pathogenesis and prevention of joint damage in rheumatoid arthritis. Advances from synovial biopsy and tissue analysisArthritis Rheum4326192633PubMedCrossRef
4.
go back to reference Lodder, MC, Haugeberg, G, Lems, WF, Uhlig, T, Orstavik, RE, Kostense, PJ, Dijkmans, PA, Kvien, TK, Woolf, AD 2003Radiographic damage associated with low bone mineral density and vertebral deformities in rheumatoid arthritis: The Oslo–Truro–Amsterdam (OSTRA) collaborative studyArthritis Rheum49209215PubMedCrossRef Lodder, MC, Haugeberg, G, Lems, WF, Uhlig, T, Orstavik, RE, Kostense, PJ, Dijkmans, PA, Kvien, TK, Woolf, AD 2003Radiographic damage associated with low bone mineral density and vertebral deformities in rheumatoid arthritis: The Oslo–Truro–Amsterdam (OSTRA) collaborative studyArthritis Rheum49209215PubMedCrossRef
5.
go back to reference Backhaus, M, Kamradt, T, Sandrock, D 1999Arthritis of the finger joints: A comprehensive approach comparing radiography, scintigraphy, ultrasound, and contrast-enhanced magnetic resonance imagingArthritis Rheum4212321245PubMedCrossRef Backhaus, M, Kamradt, T, Sandrock, D 1999Arthritis of the finger joints: A comprehensive approach comparing radiography, scintigraphy, ultrasound, and contrast-enhanced magnetic resonance imagingArthritis Rheum4212321245PubMedCrossRef
6.
go back to reference Jergas, M, Uffmann, M, Escher, H, Gluer, CC, Young, KC, Grampp, S, Koster, O, Genant, HK 1994Interobserver variation in the detection of osteopenia by radiography and comparison with dual X-ray absorptiometry of the lumbar spineSkeletal Radiol23195199PubMedCrossRef Jergas, M, Uffmann, M, Escher, H, Gluer, CC, Young, KC, Grampp, S, Koster, O, Genant, HK 1994Interobserver variation in the detection of osteopenia by radiography and comparison with dual X-ray absorptiometry of the lumbar spineSkeletal Radiol23195199PubMedCrossRef
7.
go back to reference Pietka, E, Gertych, A, Pospiech-Kurkowska, S, Cao, F, Huang, HK, Gilzanz, V 2004Computer-assisted bone age assessment: Graphical user interface for image processing and comparisonJ Digit Imaging17175188PubMedCrossRef Pietka, E, Gertych, A, Pospiech-Kurkowska, S, Cao, F, Huang, HK, Gilzanz, V 2004Computer-assisted bone age assessment: Graphical user interface for image processing and comparisonJ Digit Imaging17175188PubMedCrossRef
8.
go back to reference Malich, A, Fischer, DR, Fascius, M, Petrovitch, A, Böttcher, J, Marx, C, Hansch, A, Kaiser, WA 2005Effect of breast density on computer aided detectionJ Digit Imaging1918711889 Malich, A, Fischer, DR, Fascius, M, Petrovitch, A, Böttcher, J, Marx, C, Hansch, A, Kaiser, WA 2005Effect of breast density on computer aided detectionJ Digit Imaging1918711889
9.
go back to reference Sharp, JT, Gardner, JC, Bennett, EM 2000Computed-based methods for measuring joint space and estimating erosion volume in the finger and wrist joints of patients with rheumatoid arthritisArthritis Rheum4313781386PubMedCrossRef Sharp, JT, Gardner, JC, Bennett, EM 2000Computed-based methods for measuring joint space and estimating erosion volume in the finger and wrist joints of patients with rheumatoid arthritisArthritis Rheum4313781386PubMedCrossRef
10.
go back to reference Barnett, E, Nordin, B 1960The radiological diagnosis of osteoporosis: A new approachClin Radiol11166174PubMedCrossRef Barnett, E, Nordin, B 1960The radiological diagnosis of osteoporosis: A new approachClin Radiol11166174PubMedCrossRef
11.
go back to reference Rosholm, A, Hylsdrup, L, Baeksgaard, L, Grunkin, M, Thodberg, HH 2001Estimation of bone mineral density by digital X-ray radiogrammetry: Theoretical background and clinical testingOsteoporos Int12961969PubMedCrossRef Rosholm, A, Hylsdrup, L, Baeksgaard, L, Grunkin, M, Thodberg, HH 2001Estimation of bone mineral density by digital X-ray radiogrammetry: Theoretical background and clinical testingOsteoporos Int12961969PubMedCrossRef
12.
go back to reference Bouxsein, ML, Palermo, L, Yeung, C, Black, DM 2002Digital X-ray radiogrammetry predicts hip, wirst and vertebral fracture in elderly women: A prospective analysis from the study of osteoporotic fracturesOsteoporos Int13358365PubMedCrossRef Bouxsein, ML, Palermo, L, Yeung, C, Black, DM 2002Digital X-ray radiogrammetry predicts hip, wirst and vertebral fracture in elderly women: A prospective analysis from the study of osteoporotic fracturesOsteoporos Int13358365PubMedCrossRef
13.
go back to reference Maffei, L, Venarotti, H, Treviso, J, Sorensen, TK, Nissen, D 2000Digital X-ray radiogrammetry: A Hispanic normative reference database for the Pronosco X-Posure systemJ Bone Miner Res15304 Maffei, L, Venarotti, H, Treviso, J, Sorensen, TK, Nissen, D 2000Digital X-ray radiogrammetry: A Hispanic normative reference database for the Pronosco X-Posure systemJ Bone Miner Res15304
14.
go back to reference Malich, A, Freesmeyer, MG, Mentzel, HJ, Sauner, D, Böttcher, J, Petrovitch, A, Behrendt, W, Kaiser, WA 2003Normative values of bone parameters of children and adolescents using digital computer-assisted radiogrammetry (DXR)J Clin Densitom6103112PubMedCrossRef Malich, A, Freesmeyer, MG, Mentzel, HJ, Sauner, D, Böttcher, J, Petrovitch, A, Behrendt, W, Kaiser, WA 2003Normative values of bone parameters of children and adolescents using digital computer-assisted radiogrammetry (DXR)J Clin Densitom6103112PubMedCrossRef
15.
go back to reference Shepherd, JA, Meta, M, Landau, J, Sherrer, YSR, Goddard, DH, Ovalle, MI, Rosholm, A, Genant, HK 2005Metacarpal index and bone mineral density in healthy African-American womenOsteoporos Int1616211626PubMedCrossRef Shepherd, JA, Meta, M, Landau, J, Sherrer, YSR, Goddard, DH, Ovalle, MI, Rosholm, A, Genant, HK 2005Metacarpal index and bone mineral density in healthy African-American womenOsteoporos Int1616211626PubMedCrossRef
16.
go back to reference Wüster, C, Wenzler, M, Kappes, J, Rehm, C, Gühring, T, Arnbjerg, C 2000Digital X-ray radiogrammetry as a clinical method for estimating bone mineral density—a German reference databaseJ Bone Miner Res15298 Wüster, C, Wenzler, M, Kappes, J, Rehm, C, Gühring, T, Arnbjerg, C 2000Digital X-ray radiogrammetry as a clinical method for estimating bone mineral density—a German reference databaseJ Bone Miner Res15298
17.
go back to reference Hyldstrup, L, Jorgensen, JT, Sorensen, TK, Baeksgaard, L 2001Response of cortical bone to antiresorptive treatmentCalcif Tissue Int68135139PubMedCrossRef Hyldstrup, L, Jorgensen, JT, Sorensen, TK, Baeksgaard, L 2001Response of cortical bone to antiresorptive treatmentCalcif Tissue Int68135139PubMedCrossRef
18.
go back to reference Arnett, FC, Edworthy, SM, Bloch, DA, McShane, DJ, Fies, FJ, Cooper, NS 1988The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritisArthritis Rheum31315324PubMed Arnett, FC, Edworthy, SM, Bloch, DA, McShane, DJ, Fies, FJ, Cooper, NS 1988The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritisArthritis Rheum31315324PubMed
19.
go back to reference Larsen, A 1995How to apply Larsen score in evaluating radiographs of rheumatoid arthritis in long-term studies?J Rheumatol2219741975PubMed Larsen, A 1995How to apply Larsen score in evaluating radiographs of rheumatoid arthritis in long-term studies?J Rheumatol2219741975PubMed
20.
go back to reference Sharp, JT, Young, DY, Bluhm, GB 1985How many joints in the hands and wirst should be included in a score of radiologic abnormalities used to assess rheumatoid arthritis?Arthritis Rheum2813261335PubMed Sharp, JT, Young, DY, Bluhm, GB 1985How many joints in the hands and wirst should be included in a score of radiologic abnormalities used to assess rheumatoid arthritis?Arthritis Rheum2813261335PubMed
21.
go back to reference Haugeberg, G, Orstavik, RE, Uhlig, T, Falch, JA, Halse, JI, Kvien, TK 2002Bone loss in patients with rheumatoid arthritis. Results from a population-based cohort of 366 patients followed up to two yearsArthritis Rheum4617201728PubMedCrossRef Haugeberg, G, Orstavik, RE, Uhlig, T, Falch, JA, Halse, JI, Kvien, TK 2002Bone loss in patients with rheumatoid arthritis. Results from a population-based cohort of 366 patients followed up to two yearsArthritis Rheum4617201728PubMedCrossRef
22.
go back to reference Deodhar, AA, Brabyn, J, Jones, PW, Davis, MJ, Woolf, AD 1995Longitudinal study of hand bone densitometry in rheumatoid arthritisArthritis Rheum3812041210PubMed Deodhar, AA, Brabyn, J, Jones, PW, Davis, MJ, Woolf, AD 1995Longitudinal study of hand bone densitometry in rheumatoid arthritisArthritis Rheum3812041210PubMed
23.
go back to reference Alenfeld, FE, Diessel, E, Brezger, M, Sieper, J, Felsenberg, D, Braun, J 2000Detailed analyses of periarticular osteoporosis in rheumatoid arthritisOsteoporos Int11400407PubMedCrossRef Alenfeld, FE, Diessel, E, Brezger, M, Sieper, J, Felsenberg, D, Braun, J 2000Detailed analyses of periarticular osteoporosis in rheumatoid arthritisOsteoporos Int11400407PubMedCrossRef
24.
go back to reference Devlin, J, Lilley, J, Gough, A, Huissoon, A, Holder, R, Reece, R, Perkins, P, Emery, P 1996Clinical associations of dual-energy X-ray absorptiometry measurement of hand bone mass in rheumatoid arthritisBr J Rheumatol3512561262PubMedCrossRef Devlin, J, Lilley, J, Gough, A, Huissoon, A, Holder, R, Reece, R, Perkins, P, Emery, P 1996Clinical associations of dual-energy X-ray absorptiometry measurement of hand bone mass in rheumatoid arthritisBr J Rheumatol3512561262PubMedCrossRef
25.
go back to reference Jensen, T, Klarlund, M, Hansen, M, Jensen, KE, Podenphant, J, Hansen, TM 2004Bone loss in unclassified polyarthritis and early rheumatoid arthritis is better detected by digital radiogrammetry than dual X-ray absorptiometry: Relationship with disease activity and radiographic outcomeAnn Rheum Dis631522PubMedCrossRef Jensen, T, Klarlund, M, Hansen, M, Jensen, KE, Podenphant, J, Hansen, TM 2004Bone loss in unclassified polyarthritis and early rheumatoid arthritis is better detected by digital radiogrammetry than dual X-ray absorptiometry: Relationship with disease activity and radiographic outcomeAnn Rheum Dis631522PubMedCrossRef
26.
go back to reference Böttcher, J, Malich, A, Pfeil, A, Petrovitch, A, Lehmann, G, Heyne, JP, Hein, G, Kaiser, WA 2004Potential clinical relevance of digital radiogrammetry for quantification of periarticular bone demineralization in patients suffering from rheumatoid arthritis depending on severity and compared with DXAEur Radiol14631637PubMedCrossRef Böttcher, J, Malich, A, Pfeil, A, Petrovitch, A, Lehmann, G, Heyne, JP, Hein, G, Kaiser, WA 2004Potential clinical relevance of digital radiogrammetry for quantification of periarticular bone demineralization in patients suffering from rheumatoid arthritis depending on severity and compared with DXAEur Radiol14631637PubMedCrossRef
27.
go back to reference Böttcher, J, Pfeil, A, Rosholm, A, Malich, A, Petrovitch, A, Heinrich, B, Lehmann, G, Mentzel, HJ, Hein, G, Linß, W, Kaiser, WA 2005Influence of image-capturing parameters on digital X-ray radiogrammetryJ Clin Densitom88794PubMedCrossRef Böttcher, J, Pfeil, A, Rosholm, A, Malich, A, Petrovitch, A, Heinrich, B, Lehmann, G, Mentzel, HJ, Hein, G, Linß, W, Kaiser, WA 2005Influence of image-capturing parameters on digital X-ray radiogrammetryJ Clin Densitom88794PubMedCrossRef
28.
go back to reference Jergas, M 2003Conventional radiographs and basic quantitative methodsGrampp, S eds. Radiology of OsteoporosisSpringerBerlin6264 Jergas, M 2003Conventional radiographs and basic quantitative methodsGrampp, S eds. Radiology of OsteoporosisSpringerBerlin6264
29.
go back to reference Steinbroker, O, Traeger, CH, Batterman, RC 1949Therapeutic criteria in rheumatoid arthritisJAMA140659662 Steinbroker, O, Traeger, CH, Batterman, RC 1949Therapeutic criteria in rheumatoid arthritisJAMA140659662
30.
go back to reference Berglin, E, Lorentzon, R, Nordmark, L, Nilsson-Sojka, B, Rantapaa Dahlqvist, S 2003Predictors of radiological progression and changes in hand bone density in early rheumatoid arthritisRheumatology42268275PubMedCrossRef Berglin, E, Lorentzon, R, Nordmark, L, Nilsson-Sojka, B, Rantapaa Dahlqvist, S 2003Predictors of radiological progression and changes in hand bone density in early rheumatoid arthritisRheumatology42268275PubMedCrossRef
31.
go back to reference Jawaid, WB, Crosbie, D, Shotton, J, Reid, DM, Stewart, A 2006The use of digital X-ray radiogrammetry in the assessment of joint damage in rheumatoid arthritisAnn Rheum Dis65459464PubMedCrossRef Jawaid, WB, Crosbie, D, Shotton, J, Reid, DM, Stewart, A 2006The use of digital X-ray radiogrammetry in the assessment of joint damage in rheumatoid arthritisAnn Rheum Dis65459464PubMedCrossRef
32.
go back to reference Stewart, A, Mackenzie, LM, Black, AJ, Reid, DM 2004Predicting erosive disease in rheumatoid arthritis. A longitudinal study of changes in bone density using digital X-ray radiogrammetry: a pilot studyRheumatology4315611564PubMedCrossRef Stewart, A, Mackenzie, LM, Black, AJ, Reid, DM 2004Predicting erosive disease in rheumatoid arthritis. A longitudinal study of changes in bone density using digital X-ray radiogrammetry: a pilot studyRheumatology4315611564PubMedCrossRef
33.
go back to reference Haugeberg, G, Lodder, MC, Lems, WF 2004Hand cortical bone mass and its associations with radiographic joint damage and fractures in 50–70 year old female patients with rheumatoid arthritis: Cross sectional Oslo–Truro–Amsterdam (OSTRA) collaborative studyAnn Rheum Dis6313311334PubMedCrossRef Haugeberg, G, Lodder, MC, Lems, WF 2004Hand cortical bone mass and its associations with radiographic joint damage and fractures in 50–70 year old female patients with rheumatoid arthritis: Cross sectional Oslo–Truro–Amsterdam (OSTRA) collaborative studyAnn Rheum Dis6313311334PubMedCrossRef
Metadata
Title
Computerized Digital Imaging Techniques Provided by Digital X-ray Radiogrammetry as New Diagnostic Tool in Rheumatoid Arthritis
Authors
Joachim Böttcher, M.D.
Alexander Pfeil
Anders Rosholm, Ph.D.
Max-Ludwig Schäfer
Ansgar Malich, M.D.
Alexander Petrovitch, M.D.
Bettina Seidl
Gabriele Lehmann, M.D.
Hans-Joachim Mentzel, M.D.
Gert Hein, M.D.
Gunter Wolf, M.D.
Werner A. Kaiser, M.D., M.S.
Publication date
01-09-2006
Publisher
Springer-Verlag
Published in
Journal of Imaging Informatics in Medicine / Issue 3/2006
Print ISSN: 2948-2925
Electronic ISSN: 2948-2933
DOI
https://doi.org/10.1007/s10278-006-0263-y

Other articles of this Issue 3/2006

Journal of Digital Imaging 3/2006 Go to the issue