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Musculoskeletal system, Extremities, Musculoskeletal bone, Cone beam CT, Digital radiography, Computer Applications-Detection, diagnosis, Diagnostic procedure, Comparative studies, Arthritides, Image verification, Pathology
D. V. Makarova, C. V. Kushnir, E. Lopukhova, E. G. Gorlycheva; Moscow/RU
Methods and materials
The group of 26 patients with determined diagnosis of PsA in anamnesis and with diagnostically significant indicators in accordance with CASPAR classification was formed.
Among them there were 10 women and 16 men at the age from 24 to 65.
According to anamnestic data the duration of articular pain syndrome was 17.2 ± 1.9 months,
the amount of body surface area (BSA) was 9.8 ± 2.6 %,
the psoriasis severity index (PASI) came to 12.1 ± 3.2,
and dermatological quality of life index (DQLI) became 8.6 ± 1.0.
the results of the laboratory studies and the data of the hands and wrists SR of each patient (n = 26) was analyzed.
In this group of patients CBCT of the hands and wrists was performed for the dynamic control implementation.
Before scanning each patient signed a voluntary informed consent to participate in the X-ray study using CBCT.
CBCT of the hands and wrists was carried out using a cone-beam computed unit (NewTom 5G,
It has the following technical characteristics: 200 × 250 mm flat-panel detector size,
180 × 160 mm maximum field of view,
and a 360° gantry rotation around the region of interest.
The hand and wrist scanning was performed from the distal metaphysis of the forearm bones to the nail ends of the distal finger phalanges.
Settings were the following: scan mode — «patient scan» (exposure time — 3.6 s,
X-ray tube boosting voltage — 110 kV,
current — 0.6‒0.8 mA),
scan pattern — «regular scan»,
scan time — 18 s.
The CBCT hand and wrist examinations were carried out in special-purpose positioning setups allowing full coverage of the region of interest.
The hands and wrists joints changes have been assessed by the presence of the joints spaces narrowing and dilation,
bone proliferation (enthesophytes,
diaphyseal and metaphyseal periostitis),
concentric and eccentric erosions,
osteolysis of the articular surfaces with the formation of the «pencil-in-cap» deformities,
resorption of the terminal fingers phalanges,
All the patients were conventionally divided into 2 groups according to the forms of PsA: symmetric polyarthritis (n = 15) and arthritis mutilans (osteolitic variant) form (n = 11).
There were no patients with isolated lesions of the DIJ in the observation group.
CBCT studies were performed repeatedly to 12 patients due to the PsA exacerbation.
The obtained results were compared with the data of the previous studies.
In addition calculations of direct costs of different ray methods of the hand and wrist examination have been performed and analyzed.
The received results were compared also.