Two new papers report the use of BoneXpert to assess rheumatoid and psoriatic arthritis. They exploit the recent extension of BoneXpert's measurement of cortical thickness in the metacarpals to adults.

Over the last sixteen years, many studies have shown a connection between loss of cortical bone in the metacarpals and progression of rheumatoid arthritis. However, the clinical usefulness of this relationship has not yet been settled. The recent implementation of the method in BoneXpert could help make progress in this domain in two ways: Firstly, the standalone version makes the method available for research on retrospective data, and secondly, the server version gives efficient integration in the PACS workflow of clinical practice.

The papers are from the Pfeil-Böttcher group in Jena and show a clear relationship between the severity of psoriatic or rheumatoid arthritis and the metacarpal index, which therefore is concluded to have the potential to be a surrogate marker of radiographic progression in these disorders.

  • The first paper is in Arthritis Research & Therapy, freely available here
  • The second paper is in BMC Musculoskeletal Disorders, freely available here 

Today the assessment of radiological progression of arthritis is based on manual scoring, but there is little doubt that in the future we will see computerized methods coming into use as a result of the general movement towards automated, quantitative radiology and artificial intelligence. 

BoneXpert is a pioneer in this field. It has the advantages that it runs on a local computer at the hospital and does not require oversight from a central reading center. It offers a high degree of self-validation, and the result is available almost immediately. These workflow aspects are important for the clinical value.

However, more research is needed, and we encourage researches in this area to contact Visiana for inquiring about the availability of the new method for clinical studies and clinical trials.