Isolated bone erosions likely not clinically significant

Background: Synovial joint erosions are generally considered the result of an inflammatory process, permitting identification of the underlying form of arthritis.However, they are sometimes perceived in isolation, in the absence of any disorder known to produce erosions.In addition to the character of the erosions, a tool helpful in characterizing known forms of inflammatory arthritis is their gender and age distribution as a population phenomenon.Methods: Hands and feet of individuals in the Hamann-Todd human skeletal collection were macroscopically examined to identify individuals with isolated (single or two) appendicular articular or peri-articular cortical disruptions in absence of axial skeletal erosions, fusion, syndesmophytes or calcium pyrophosphate deposition disease-related calcific deposits.Gender and age were additionally recorded for individuals identified with rheumatoid arthritis, spondyloarthropathy and calcium pyrophosphate deposition disease.Results: Isolated articular and periarticular cortical disruption was recognized in 61 (4 women, 57 men) among 1620 individuals, independent of race.Discussion: Epidemiologic analysis revealed a pattern of isolated erosions that could not be attributed to the diseases that today are recognized to commonly cause bone erosion.If not associated with other skeletal manifestations of inflammatory/crystalline arthritis or clinical evidence of synovitis, they likely are not clinically significant.