High-resolution peripheral quantitative computed tomography imaging in the assessment of periarticular bone of metacarpophalangeal and wrist joints

<p><strong>Objective: </strong> To synthesize descriptions of periarticular findings at the metacarpophalangeal (MCP) and wrist joints in different types of arthritis and in the normal state imaged by high-resolution peripheral quantitative computed tomography (HR-pQCT); to assemble the literature reporting on the ability of HR-pQCT to detect findings relative to other imaging modalities; and to collate results on the reproducibility of image interpretation.</p> <p><strong>Methods: </strong> A systematic literature review was performed using terms for HR-pQCT and MCP or wrist joints using medical literature databases and conference abstracts. Any study describing predefined pathology findings, comparison to another radiographic technique, or a measure of reproducibility was included with no limitation by disease state.</p> <p><strong>Results: </strong> We identified 44 studies meeting inclusion criteria from the 1901 articles identified by our search. All 44 reported on pathology findings, including erosions (<i>n</i> = 31), bone microarchitecture (<i>n</i> = 10) and bone mineral density (<i>n</i> = 10) variables, joint space evaluation (<i>n</i> = 7), or osteophyte characterization (<i>n</i> = 7). Seventeen of the studies compared HR-pQCT findings to either plain radiography (<i>n</i> = 9), ultrasound (<i>n</i> = 4), magnetic resonance imaging (<i>n</i> = 5), or microcomputed tomography (<i>n</i> = 2), with HR-pQCT having high sensitivity for erosion detection. Twenty-four studies included an assessment of reproducibility with good to excellent metrics, and highlighting the critical importance of positioning when assessing joint space variables.</p> <p><strong>Conclusion: </strong> Despite high sensitivity for erosion detection and good reproducibility, more research is required to determine where HR-pQCT can be applied to enhance our understanding of periarticular bone changes in a variety of arthritis conditions.</p>