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The data obtained showed significantly lower bone quality (lower TBS and BMD) in SSc and RA patients compared with CNT. The bone quality seemed lower in SSc patients with more altered microvasculature (late NVC pattern).

Osteoporosis is predominantly a condition of the elderly with a consequent increase in bone fragility and susceptibility to fracture. A number of clinical as well as biological studies have been pivotal in providing us with an understanding of the pathophysiology of this condition. This article discusses the current concepts of age-related osteoporosis.

BackgroundPatients affected by Rheumatoid Arthritis (RA) show an increased risk of low bone mass, as a result of multi-systemic disorders including toxic drug, low vitamin D levels and physical inactivity. Trabecular Bone Score (TBS), is an index extracted from the dual-energy X-ray absorptiometry (DXA) images, that provides an indirect measurement (Score) of bone axial microarchitecture and allows to get information about bone quality (1,2).ObjectivesThe aim of this investigation was to evaluate bone quality in RA patients (high risk population) receiving vitamin D supplementation from at least 3 month, using the TBS.Methods108 female patients (mean age 61±8 years) affected by RA and 60 age- matched controls (CNT) (mean age 64±11 years) were enrolled. Bone Mineral Density (BMD, g/cm2) of the lumbar spine (L1-L4) was analyzed using a DXA scan (GE,Lunar Prodigy). Lumbar spine TBS (TBS iNsight Medimaps) was derived for each spine DXA examination. All patients were evaluated for serum 25 hydroxyvitamin D (25(OH)D) concentrations.Results78 RA patients (80%) presented a bone loss that was significantly lower when compared with control group (p<0.001). Likewise, lumbar spine TBS score was found significantly lower in RA patients compared with CNT (p<0.001). Finally, RA patients showed lower 25(OH)D concentrations (18.4±1.3 ng/ml) than CNT (26.2±0.9 ng/ml; p<0.04).ConclusionsThis study shows in RA patients a reduction of TBS values that seem placed side by side with reduced BMD values and 25(OH)D serum concentrations. Therefore, TBS could become a new and safe diagnostic tool for the quantification of the bone quality and related osteoporosis, in chronic systemic inflammatory rheumatic diseases, such as RA.References Sinigaglia L, et al. Rheum Dis Clin North Am. 2006;32:631–58.Avouac J, et al. Arthritis Care Res 2012;64:1871–8. Disclosure of InterestNone declared

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