Differentiation of physiological from pathological bone erosions in rheumatoid arthritis: an 8-year high-resolution peripheral quantitative computed tomography (HR-pQCT) study of the second metacarpal head
Authors' conclusion
Small erosions are common in both RA and healthy individuals and remain stable long term in RA, supporting their interpretation as physiological/biomechanical (noninflammatory) variants rather than RA pathology. In contrast, large erosions are specific to RA and show significant capacity for repair under early, aggressive T2T management.
Study context
- Population
- Patients with rheumatoid arthritis (RA) from 2 cohorts (early and established RA) and age- and sex-matched healthy controls (HCs)247 RA, 78 HCs
- Participants
- 247 / 78 / 98 / 149
- Comparison
- RA vs age- and sex-matched HCs; ERA vs established RA over 8 years
- RAn = 247
- HCsn = 78reference
- ERAn = 98
- Established RAn = 149reference
- Outcome
- Erosion prevalence and size vs HCs at baseline, and long-term erosion volumetric change and treatment response on HR-pQCT
Methodological detailsage- and sex-matched healthy controls, HR-pQCT of the second metacarpal head, rescan after a median of 8 years, logistic regression
- Age- and sex-matched healthy controls
- HR-pQCT of the second metacarpal head
- Rescan after a median of 8 years
- Logistic regression
Main finding
As reported in the abstract
Erosion prevalence by size, RA vs HCs · baseline
- Small erosions (< 1 mm³) similarly prevalent in RA and HCs
- RA vs HCs: P < 0.003
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Regression of large erosion (patients with large erosions) · median 8 yearsERAvs Established RA | 6.93 (1.57–30.56) | P = 0.011 | |
| 0.050.21520Odds ratio (log scale) |
- Regression of large erosion (patients with large erosions): logistic regression; ERA cohort independently predicted regression
Erosion volumetric change in RA · median 8 years
- Small erosions highly stable with minimal volumetric change
- Large erosions decreased substantially in volume
Original publication
Differentiation of physiological from pathological bone erosions in rheumatoid arthritis: an 8-year HR-pQCT study of the second metacarpal head. Ann Rheum Dis. Published 10 April 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →