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Cone Beam Computed Tomography for Assessment of Erosions in Early Rheumatoid Arthritis: A Pilot Study
Inger Gjertsson1, Ylva Aurell2, Anna Rudin1
1I. Gjertsson, MD, PhD, A. Rudin, MD, PhD, A.K.H Ekwall, MD, PhD, E. Klingberg, MD, PhD, Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, and Department of Rheumatology, Sahlgrenska University Hospital, Section of Rheumatology, Gothenburg.
Objective:
Cone beam computed tomography (CBCT) can accurately assess erosive disease in the hands, wrists, and feet in established rheumatoid arthritis (RA). The aim of this study was to compare CBCT with conventional radiography (CR) for the assessment of erosions in patients with early RA.
Methods:
CBCT and CR of the hands, wrists, and feet of 17 patients with treatment-naive early RA were assessed at diagnosis and at the 6-month and 12-month follow-up. Erosions on CBCT scans were scored by the same observer using the modified RA Magnetic Resonance Imaging Score, which evaluates the same joints as the Sharp/van der Heijde score (SHS). Radiographs were scored for erosions using the SHS by the same observer.
Results:
At baseline, there was a significant difference in the erosion score between CBCT and CR, as shown with a percentage of maximum scores. The number of erosions and the number of eroded joints were significantly higher with CBCT compared with CR at 6 and 12 months. The number of detected repair of erosions was higher with CBCT than with CR at both 6 and 12 months.
Conclusion:
CBCT was more sensitive than CR in detecting erosions and repair in patients with early RA. CBCT has the potential to become a sensitive tool for monitoring destructive disease in patients with RA.
