Influence of age, sex, and growth variables on phalangeal quantitative ultrasound measures: a study in healthy children and adolescents.

Skeletal status by phalangeal quantitative osteosonography (DBM Sonic BP-IGEA) was examined in 1227 healthy children (641 boys and 586 girls) aged 3-16 years. Aims of the study were to evaluate some physical parameters pertaining to the ultrasound transmission crossing the phalanx in a school-age population and to relate these values to age, sex, and growth variables. A correlation was found between AD-SoS (amplitude-dependent speed of sound) and BTT (bone transmission time) and, age, height, weight, and pubertal stage, respectively. No correlation existed between FWA (fast wave amplitude) and SDy (dynamics of the ultrasound signal) and age, height, weight, pubertal stage, and BMI, respectively. AD-SoS increased in boys until 7-8 years of age. Thereafter a plateau was reached up to age 12-13 years, when a rapid increase was observed corresponding to pubertal growth rate acceleration. In girls, AD-SoS increased with age up to 10-11 years with a steeper increase at the time of puberty starting about 2 years earlier than in boys. BTT presented a similar trend. Mean AD-SoS values increased from Tanner pubertal stages 1 to 2 and from stage 3 to 4 in both sexes. Significantly higher mean AD-SoS values in stages 2, 3, and 4 were observed in girls as compared to boys. Mean BTT values increased significantly from stage 1 to 5 in girls and from 1 to 4 in boys. QUS technology showed the ability to assess bone changes in the growing bone.

Hematic levels of type I collagen C-telopeptide in erosive versus nonerosive osteoarthritis of the hands.

C-telopeptide of type I collagen (CTX I) is considered to be a specific marker sensitive to bone resorption; conversely, type II collagen C-telopeptide (CTX II) is considered to be a useful cartilage marker. CTX I assays in serum and urine samples of patients with various metabolic bone disorders, such as osteoporosis and Paget's disease, have been reported to show increased levels of this collagen fragment. In patients with knee osteoarthritis, a decrease in CTX I and an increase in CTX II were found. Osteoarthritis of the hands is one of the most common forms of osteoarthritis. Erosive osteoarthritis of the hands is a variant entity in which, as a consequence of rapid chondrolysis, bone involvement occurs very early in the process. The aim of this cross-sectional study was to compare CTX I assays in patients with erosive osteoarthritis of the hands versus those with nonerosive osteoarthritis of the hands. From a group of over 200 patients fulfilling the American College of Rheumatology's criteria for hand osteoarthritis, we considered the first 21 consecutive postmenopausal women with hand nodal osteoarthritis and disease duration of > or = 5 years and the first 21 consecutive postmenopausal women additionally presenting central joint erosions and disease duration of > or = 5 years. Our results show that in patients with erosive osteoarthritis, CTX I values are much higher than those in patients with nonerosive osteoarthritis.

Early-morning administration of dexketoprofen-trometamol in morning stiffness induced by nodal osteoarthritis of the hands.

Morning stiffness in osteoarthritis (OA) of the hands is a troublesome symptom that deserves attention in many OA patients. The aim of this research was to verify the action of oral dexketoprofen-trometamol (50 mg) administered early in the morning on morning stiffness in hand OA. Thirty-five patients were compared with 19 controls. The degree of morning stiffness, evaluated by means of the WOMAC scale for OA stiffness, was significantly diminished 40 min after drug administration in treated patients but not in controls. This drug acted rapidly and was effective in reducing morning stiffness in OA of the hands.

Tissue changes detectable by sonography before radiological evidence of elbow chondrocalcinosis.

Chondrocalcinosis is a joint disease caused by deposits of calcium pyrophosphate dihydrate (CPPD) crystals with manifestations that may include intermittent attacks of acute arthritis or enthesitis. If no crystals are found on synovial analysis, the diagnosis in clinical practice is based on typical radiographic findings, although it is now recognized that some signs of the disease could also be seen by ultrasound. We studied six patients with elbow enthesopathy without radiographic evidence of CPPD that presented ultrasound findings suggesting joint calcification. On the basis of these echographic findings, the diagnosis was then ascertained by x-ray examination of the most commonly involved joints. Ultrasound is a method of proven interest in the evaluation of rheumatic patients and could be an important tool in diagnosing CPPD.

Disodium clodronate in painful nonresponsive periarthropathy of the hip.

This article identifies and describes a small group of patients with trochanteric tendinitis and bursitis in whom all modes of traditional therapy failed. We hypothesized that obstinate pain could be due to an increase in bone turnover associated with the formation of marginal bony outgrowths or enthesophytes. Injectable disodium clodronate is known to be highly efficacious in inhibiting bone reabsorption and is able to reduce several types of bone pain. The aim of the study was to evaluate the effectiveness of disodium clodronate in periarticular pathology of the hip in a group of patients resistant to traditional treatments and who were hypothesized to have a component of bone pain in their pain syndrome. Periarticular ultrasound examination is a useful method for detecting soft tissue alterations and is of interest in the study of these patients. In this study ultrasound examination showed periarticular alterations even when results of radiography were negative. Reduction in the hyperechoic ultrasound image, which confirms periarticular calcification, was observed in 75% of the patients treated with disodium clodronate vs. 33% of those treated with paracetamol. At the end of the study, all patients treated with disodium clodronate had a reduction in spontaneous and provoked pain > or = 1/3 vs. the basal visual analogue scale, unlike those treated with paracetamol.

Quantitative ultrasound of the proximal phalanges: reproducibility in erosive and nodal osteoarthritis of the hands.

The aims of the study were to evaluate the reproducibility of quantitative ultrasound (QUS) densitometry of the hands and to verify whether this method is sensitive to phalangeal bone changes occurring in osteoarthritis patients and in erosive osteoarthritis patients. We studied 60 postmenopausal women (aged 63.8 +/- 3.2): 20 had osteoarthritis, 20 had erosive osteoarthritis, 20 were postmenopausal without local pathology of the hand and eight were premenopausal (aged 23.5 +/- 3.4). The patients were evaluated by means of a DBM Sonic 1200 which is able to evaluate ultrasound transmission velocity (amplitude-dependent speed of sound). The results indicated good intra- and interoperator reproducibility (coefficient of variation = 0.99% and 1.04%) in the premenopausal group. The ultrasound device was able to discriminate between the different groups and detected differences between the QUS values of erosive osteoarthritis patients, osteoarthritis patients and control subjects. QUS densitometry is reproducible and sensitive to bone changes occurring in patients with osteoarthritis and as well as in those with erosive osteoarthritis.