gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie
74. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie
96. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie
51. Tagung des Berufsverbandes der Fachärzte für Orthopädie und Unfallchirurgie

26. - 29.10.2010, Berlin

Bone micro-architecture of finger joints measured with high-resolution pQCT – feasibility study and first results from healthy volunteers

Meeting Abstract

  • J. Goldhahn - Schulthess Klinik, Obere Extremitäten, Zürich, Switzerland
  • K. Stok - ETH Zürich, Institut für Biomechanik, Zürich, Switzerland
  • T.L. Müller - ETH Zürich, Institut für Biomechanik, Zürich, Switzerland
  • R. Müller - ETH Zürich, Institut für Biomechanik, Zürich, Switzerland
  • C. Kolling - Schulthess Klinik, Obere Extremitäten, Zürich, Switzerland

Deutscher Kongress für Orthopädie und Unfallchirurgie. 74. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 96. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 51. Tagung des Berufsverbandes der Fachärzte für Orthopädie. Berlin, 26.-29.10.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocIN24-1633

DOI: 10.3205/10dkou157, URN: urn:nbn:de:0183-10dkou1576

Veröffentlicht: 21. Oktober 2010

© 2010 Goldhahn et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Radiographic monitoring of treatment success in inflammatory diseases affecting hand and finger joints is limited to semi-quantitative rating of standard X-rays. High resolution peripheral quantitative computed tomography (HR-pQCT) has been utilized successfully in other locations, e.g. distal radius, to obtain additional information. Our group developed appropriate positioning methods to facilitate the measurements of micro-architecture in small bones such as in fingers as well as procedures for quantification of these structures. The goal of this study was to quantify bone structural parameters in finger bones from a group of healthy volunteers that were gender- and age-matched to a group of patients with RA to serve as a healthy control group for an ongoing clinical study.

Methods: Nineteen healthy volunteers (aged 39 to 69) completed a set of subjective questionnaires and clinical examination to ensure normal hand function. High-resolution-pQCT measurements were performed at the metacarpal-phalangeal (MCP) and at the proximal interphalangeal (PIP) joints of the right hand. Subsequently, standard morphometric parameters e.g. average bone density (D100), cancellous bone volume density (BV/TV), cortical thickness (Ct.Th.), and trabecular number (Tb.N).), were computed, calculated separately for trabecular and cortical compartment, and stratified for proximal and distal joint parts. The values were compared between the two joint parts, within one finger and with the same region at the other finger using Wilcoxon-Ranking test and Spearman correlation coefficient.

Results and conclusions: Image quality was sufficient in all cases to determine morphometric parameters. Although significant differences in bone density and structural parameters between joint parts, joints and fingers were detected, moderate to high correlations (red arrows in figure 2) were detected. Highest correlations were found for similar joint parts of different fingers, e,g, D100 from proximal part of MCP II correlates strongly with corresponding part of MCP III (r=0.84) but only moderate with distal part of MCP II (r=0.695) and only weak with proximal part of PIP II (r=0.479). We found similar correlations for all morphometric parameters.

The study demonstrates the feasibility of determining morphometric parameters of finger joints utilizing HR-pQCT. The data show distinct patterns of structural relations between joint parts, joints of the same finger and different fingers that can be utilized for analyzing structural changes, e.g. in rheumatoid arthritis and for implant development.