Abstract

BackgroundPsoriasis (Pso), psoriatic arthritis (PsA) and rheumatoid arthritis (RA) are inflammatory diseases. PsA and RA are characterized by bone and muscle loss. In RA, bone loss has been extensively characterized, but muscle loss has, to the best of our knowledge, not been quantified to date.MethodsA random forest based segmentation method was used to analyze hand muscle volume in T1 weighted MRI images of 330 patients suffering from Pso, PsA or RA. In addition, fat volume was quantified using MRI Dixon sequences in a small subset (n = 32).ResultsMales had a higher relative muscle volume than females (14% for Pso, 11% for PsA, n.s. for RA). Between 40 and 80 years male Pso patients lost 13%, male PsA patients 16%, male RA patients 23% and female PsA patients 30% of their relative muscle volume. After adjustment for age, relative muscle volume in males RA patients was 16% and in female RA patients 9% lower than in Pso patients. In male RA patients relative muscle volume was 13% lower in than in male PsA patients. There was no difference in females. A significant negative correlation (R2 = 0.18) between relative intramuscular fat content relative hand muscle volume was observed.ConclusionThese preliminary data showed that relative hand muscle volume significantly decreased with age in male and female patients with Pso, PsA and RA patients. Independent of age, relative hand muscle volume was significantly smaller in patients with RA compared to the patients with Pso and the difference was twice as large in males compared to females. Also in male but not in female RA patients relative hand muscle volume was significantly smaller than in PsA patients.

Highlights

  • Psoriasis (Pso), psoriatic arthritis (PsA) and rheumatoid arthritis (RA) are inflammatory diseases

  • Between 20 and 80 years, hand volume of males decreased by 17% in RA patients, increased by 9% in Pso patients and did not change in PsA patients

  • The central findings of this study showed that the age related decrease of relative hand muscle volume in males was larger than in females (Table 5 and Figs. 6 and 7) and that in males but not in females relative muscle volume was lower in RA than in PsA or Pso patients, independent of age

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Summary

Introduction

Psoriasis (Pso), psoriatic arthritis (PsA) and rheumatoid arthritis (RA) are inflammatory diseases. PsA and RA are characterized by bone and muscle loss. In RA, bone loss has been extensively characterized, but muscle loss has, to the best of our knowledge, not been quantified to date. Rheumatoid arthritis (RA) is a chronic inflammatory disease, which is associated with bone and cartilage loss [1]. About two thirds of RA patients suffer from rheumatoid cachexia (RC) [1], an accelerated involuntary loss of fat-free skeletal muscle mass, which is larger than the decrease related to ‘normal’ aging (sarcopenia). For the diagnosis of RC, advanced muscle and fat imaging is required. The sole use of BMI for the diagnosis of RC is misleading

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