Pseudoerosions of Hands and Feet in Rheumatoid Arthritis: Anatomic Concepts and Redefinition
Abstract
:1. Introduction
2. Materials and Methods
2.1. Search Strategy
2.2. Selection Criteria
3. Results
3.1. Anatomic Pseudoerosions
3.2. Artifact-Related Pesudoerosions
4. Discussion
4.1. Anatomic Pseudoerosions
4.2. Artefact-Related Pseudoerosions
4.3. Erosions-in-Pseudoerosions
4.4. Limitations
5. Conclusions
6. Take Home Message
- Pseudoerosions may be subclassified into anatomic (normal osseous cavity) and artefact-related (artefactual interruption of the calcified zone).
- The term “calcified zone” describes the deep components of the subchondral, subligamentous and subtendinous bone and may be applied for all non-cancellous borders of a bone.
- Pseudoerosions can be regarded as anatomic sites at risk for the development of “true” arthritic erosions.
Author Contributions
Conflicts of Interest
References
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Citation | Type of Article | Imaging Modality | Reported Pseudoerosion | Explanation |
---|---|---|---|---|
Alasaarela et al., 1998 [58] | Original research | Magnetic resonance imaging (MRI) (1.0T T1, T2 and proton density, PD) | False positive interpretation | Pre-erosive oedematous changes in subchondral bone in MRI |
Barnabe et al., 2016 [11] | Original research | High-resolution peripheral quantitative computed tomography (HRpqCT) | Carpal pseudoerosions | Arterial foramina |
Canella Moraes Carmo et al., 2009 [54] | Original research | Computed tomography (CT) | Carpal pseudoerosions | ligament insertions tendinous sulci |
Dohn et al., 2006 [53] | Original research | Sonography | Erosion-like changes | Metacarpophalangeal (MCP) joints |
Dohn et al., 2013 [57] | Original research | Sonography | False positive interpretation | Cortical irregularities (osteophytes, notches at the metacarpal neck, subcortical bone cysts) |
Ejbjerg et al., 2004 [44] | Original research | MRI (1.0 T1 spin echo, STIR, T2 spin echo fat-suppressed | Erosion-like changes | Capitate, lunate |
Martel et al., 1965 [3] | Original research | Plain radiography | Carpal pseudoerosion | Normal deep groove in the capitate in about 10% |
McQueen et al., 2005 [51] | Review article | MRI (T1, T2 fat-saturated) | False positive interpretation | Attachments of interosseous ligaments of the wrist, articular ligaments of the MCP joints, nutrient foramina |
Peluso et al., 2015 [52] | Original research | 3D sonography | False positive interpretation | Arterial foramina Osteophytes |
Robertson et al., 2006 [56] | Original research | MRI (1.5T, T1 spin echo, fat-suppressed FSE, fat-suppressed PD-weighted FSE, 3D SPGR) | Carpal pseudoerosions | ligament insertions |
Torshizy et al., 2008 [55] | Original research | CT | Tarsal pseudoerosions | attachment site of joint capsule ligament insertions tendinous sulci |
Wawer et al., 2014 [41] | Original research | Plain radiography | Carpal pseudoerosions | ligament insertions |
Citation | Type of Article | Imaging Modality | Reported Problem |
---|---|---|---|
Alasaarela et al., 1998 [58] | Original research | CT | Examination of a curvilinear object—the more the reformat plane parallels the z-axis, the more resolution of multiplanar reformats is impaired. The partial volume effect is harmful. |
Plain radiography | Information dependent on projections used | ||
Albrecht et al., 2013 [1] | Original research | Plain radiography | 2D character of radiography |
CT | No simultaneous assessment of inflammatory changes of RA | ||
Amin et al., 2012 [62] | Original research | Plain radiography | Beam has to hit erosion tangentially to show cortical break |
Aurell et al., 2018 [63] | Original research | Plain radiography | Possibility of false negative evaluation, if the orifice of the erosion is not hit tangentially |
Cimmino et al., 2002 [60] | Original research | MRI (T2 spin echo or gradient echo) | Failed fat suppression can mimic bone marrow edema |
Dohn et al., 2013 [57] | Original research | Sonography | Some areas of hand and wrist are inaccessible for ultrasound beam |
Dohn et al., 2008 [65] | Original research | MRI (0.6T T1 3D fast field echo) | Overestimation of erosion size due to difficult differentiation between cortical bone and erosion |
Ejbjerg et al., 2006 [64] | Original research | Plain radiography | Up to 30% of an MCP joint bone has to be eroded before detection |
Emond et al., 2012 [68] | Original research | MRI (1T 3D spoiled gradient echo) | Boundaries of erosions difficult to differentiate |
Foley-Nolan et al., 1991 [59] | Original research | Plain radiography | Erosions only visible when large percentage of bone thickness has been destroyed |
Forslind et al., 2003 [61] | Original research | Plain radiography | Delineation of erosions difficult in patients with osteoporosis |
MRI (1.0T 3D T2 gradient echo, T1 spin echo with and without fat-saturation) | False negative interpretation due to contiguous looking erosions | ||
Kleyer et al., 2016 [66] | Original research | MRI (1.5T T1) | Small cortical breaks not seen on MRI—validation by HRpqCT |
McQueen et al., 1998 [69] | Original research | MRI (1.5T T1 and T2 with and without fat suppression) | Partial volume artefacts may lead to false positive indications of erosions |
McQueen et al., 2001 [70] | Original research | Plain radiography | Identification of erosions hampered by poor visibility at the carpus |
Peluso et al., 2015 [52] | Original research | Ultrasonography | Due to anatomical structure, multiplanar distribution of bones that restricts the ultrasound beam and alters the correct visualization |
Ulas et al., 2019 [67] | Original research | MRI (1.5T): Susceptibility-weighted imaging, SWI T1w | False positive identification of erosions due to motion artefacts, strong susceptibility artefacts at tissue intersections Weak differentiation of cortical bone |
Wakefield et al., 2000 [5] | Original research | Plain radiography | Typical anatomical location of bone erosions difficult to see until it lies in the tangential plane of the radiographic beam. |
Plain radiography | Periarticular osteoporosis | ||
Wawer et al., 2014 [41] | Original research | Plain radiography | Less density in subcortical cancellous bone due to synovial and bony hyperemia, overlapping of carpal bones, presence of osteophytes |
Location | Name | Description |
---|---|---|
Scaphoid waist, palmar aspect | Scaphoid waist | Tendon hood of radial-sided carpal tunnel with radio-scapho-capitate ligament |
Scaphoid, radial aspect of midpart | Scapho-capsular ligament or mucosal fold insertions | |
Capitate, distal ulnar portion [41] | Ulnar capitate notch | Intercarpal ligaments |
Capitate, radial portion | Radial capitate notch | Intercarpal ligaments |
Lunate, radial aspect | Scapholuntate ligament | |
Hamate, distal radial portion [41] | Insertion of capitatohamate ligament and carpometacarpal ligaments | |
Hamate, distal ulnar portion [41] | Insertion of carpometacarpal ligaments | |
Triquetrum, radial and dorsal aspect | Radial triquetral notch | Insertion of the radiotriquetral ligament |
Triquetrum, ulnar and proximal aspect | Insertion of the ulnotriquetral ligament | |
Metacarpal bases | metacarpal base notches | Insertion of intercarpal ligaments |
Metacarpal or metatarsal neck and heads | metacarpal or metatarsal head notch | Insertion of metacarpophalangeal ligaments or joint capsule |
5th metatarsal head | Slight normal varus angulation of metatarsal head | |
Achilles tendon insertion | Insertion jutty |
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Hirtler, L.; Rath, C.; Platzgummer, H.; Aletaha, D.; Kainberger, F. Pseudoerosions of Hands and Feet in Rheumatoid Arthritis: Anatomic Concepts and Redefinition. J. Clin. Med. 2019, 8, 2174. https://doi.org/10.3390/jcm8122174
Hirtler L, Rath C, Platzgummer H, Aletaha D, Kainberger F. Pseudoerosions of Hands and Feet in Rheumatoid Arthritis: Anatomic Concepts and Redefinition. Journal of Clinical Medicine. 2019; 8(12):2174. https://doi.org/10.3390/jcm8122174
Chicago/Turabian StyleHirtler, Lena, Claus Rath, Hannes Platzgummer, Daniel Aletaha, and Franz Kainberger. 2019. "Pseudoerosions of Hands and Feet in Rheumatoid Arthritis: Anatomic Concepts and Redefinition" Journal of Clinical Medicine 8, no. 12: 2174. https://doi.org/10.3390/jcm8122174