Human cadaveric study has indicated that the metacarpal head (MCH) is intracapsular in location. We hypothesized that exposure to the intra-articular inflammatory milieu in psoriatic arthritis (PsA) will lead to bone loss in the MCH. INTRODUCTION To compare the bone structure and microstructure in the MCH between patients with PsA and healthy controls by high-resolution peripheral quantitative CT (HR-pQCT), and to ascertain factors associated with bone loss in PsA patients. METHODS Sixty-two PsA patients without joint destruction and 62 age-, gender-, and body mass index-matched healthy subjects underwent HR-pQCT imaging of the second and third MCH (MCH 2&3). The number and volume of bone erosion and enthesiophytes, as well as volumetric bone mineral density (vBMD) and microstructure at the MCH 2&3, were recorded. Correlation analysis and multivariable linear regression models were used to determine the association of demographic and disease-specific variables with compromised bone structure and microstructure in PsA. RESULTS At the MCH 2&3, bone erosion (p = 0.003) and enthesiophyte (p = 0.000) volumes in PsA patients were significantly larger than healthy controls. In PsA patients, older age was associated with a larger erosion and enthesiophyte volume. Concerning the mean vBMD and microstructure at the MCH 2&3, PsA patients had significantly lower mean vBMD (average vBMD - 6.9%, trabecular vBMD - 8.8%, peri-trabecular vBMD - 7.7%, meta-trabecular vBMD - 9.8%), trabecular bone volume fraction (- 8.8%), and trabecular thickness (- 8.1%) compared with control subjects. Multivariable regression analysis revealed that older age and a higher C-reactive protein level were associated with trabecular bone loss. CONCLUSIONS PsA patients had a higher burden of bone damages (erosions and enthesiophytes) and trabecular bone loss compared with healthy control at the MCH. Inflammation contributed to the deterioration in trabecular microstructure in these patients.

中文翻译：

---

银屑病关节炎患者与健康对照者掌骨头部的骨结构和微结构的比较：一项HR-pQCT研究。

人类尸体研究表明，掌骨头（MCH）位于包膜内。我们假设银屑病性关节炎（PsA）暴露于关节内炎性环境会导致MCH骨丢失。前言通过高分辨率外周定量CT（HR-pQCT）比较PsA患者和健康对照者的MCH的骨结构和显微结构，并确定与PsA患者骨丢失相关的因素。方法对62例无关节破坏的PsA患者以及62例年龄，性别和体重指数匹配的健康受试者进行了第二和第三MCH（MCH 2＆3）的HR-pQCT成像。记录了MCH 2＆3处骨侵蚀和内生菌的数量和体积，以及骨矿物质的体积密度（vBMD）和显微结构。相关分析和多元线性回归模型用于确定人口统计学和疾病特异性变量与PsA中受损的骨结构和微结构的关联。结果在MCH 2＆3处，PsA患者的骨侵蚀（p = 0.003）和内生菌（p = 0.000）的体积显着大于健康对照组。在PsA患者中，年龄较大与糜烂和内生菌的数量更大有关。关于MCH 2＆3的平均vBMD和微结构，PsA患者的平均vBMD明显较低（平均vBMD-6.9％，小梁vBMD-8.8％，小梁周围vBMD-7.7％，间小梁vBMD-9.8％），小梁骨与对照组相比，体积分数（-8.8％）和小梁厚度（-8.1％）。多变量回归分析显示，老年和较高的C反应蛋白水平与小梁骨丢失有关。结论与MCH健康对照组相比，PsA患者的骨损伤（侵蚀和内生真菌）和小梁骨丢失的负担更高。炎症导致这些患者的小梁微结构恶化。