Objective-A total of 979 women from the Chingford general population survey were studied to examine the hypothesis that osteoarthritis (OA) and osteoporosis are inversely related.Methods-All women had radiographs of the hands and knees. A total of 579 also had AP radiographs of the lumbar spine which were graded for the presence of osteophytes. All women had bone densitometry performed at the lumbar spine (L1-L4) and femoral neck. Mean bone densities (BMD) were compared between those with disease and those with no disease at any other sites. All results were adjusted for age and body mass index (BMI).Results-All OA groups had significantly higher bone density than controls at the lumbar spine. For distal interphalangeal (DIP) OA (n = 140) the difference was +5.8% (+3.0, +8.6), for carpometacarpal (CMC) OA (n= 160) +3.0% (+0*1, +5.9), for knee OA (n = 118) +7*6% (+4.3, +10.9), and lumbar spine OA (LSOA) (n = 194) +7.8% (+6.0, +8-8). Those with generalised OA (GOA n = 22), a combination of knee, DIP and CMC OA had an increase of +9-3 (+2.0, +16.6). For the femoral neck BMD was also increased significantly ranging from +2.5% for the CMC, +6-2% for the knee and +6.3% in the lumbar spine OA group. The risk of knee OA for women in the top tertile of BMD was [2][3][4][5][6][7][8][9][10][11][12][13] (1. 15-3-93 Others, however, have failed to find a relationship. Price found a significant difference in bone mineral density (BMD) when adjusting for age, which disappeared after adjusting for height and weight.6 Other studies have also been inconclusive.7 Much of the previous studies were based on small numbers with often poorly matched controls, and using relatively crude techniques to detect bone loss. Many subjects had advanced disease and if OA has been present for some time the resulting immobility is likely to affect bone mass. We therefore chose to examine the relationship between bone density and early OA of the hand, knee and spine using a middle-aged general population sample and high precision dual x ray absorbtiometry of the spine and femoral neck (FN). The area is predominantly middle class but with a range of all social groups. A socioeconomic profile was performed using the Acorn classification system which is based on each subject's postcode and residence (CACI

Objective. To examine the natural history, role of risk factors, and incidence of knee osteoarthritis (OA) in a prospective study of women from a population cohort.Methods. Women from the Chingford Study who had been recruited in 1989 were followed up with knee radiographs 4 years later. A total of 715 paired radiographs (71% of the original sample) were graded for osteophytes and 644 for joint space narrowing (JSN). Women whose radiographs had been graded as 0 in 1989 and as >14 years later were classified as having incident disease. Incident cases were compared with controls for associations with a number of risk factors.Results. Eighty-one women (12.6%) developed JSN of the knee, equating to an incidence of 3.

Joint damage progresses constantly over the first 20 yr of RA. It accounts for approximately 25% of disability in established RA. The link between damage and disability is strongest in late (>8 yr) RA. However, avoiding or reducing joint damage in both early and established/late RA is likely to maintain function.

Objective. To estimate the risk of osteoarthritis (OA) of the hip and knee due to long-term weightbearing sports activity in ex-elite athletes and the general population.Methods. A retrospective cohort study was conducted of 81 female ex-elite athletes (67 middle-and long-distance runners, and 14 tennis players), currently ages 40-65, recruited from original playing records, and 977 age-matched female controls, taken from the age-sex register of the offices of a group general practice in Chingford, Northeast London, England. The definition of OA included radiologic changes (joint space narrowing and osteophytosis) in the hip joints, patellofemoral (PF) joints, and tibiofemoral (TF) joints.Results. Compared with controls of similar age, the ex-athletes had greater rates of radiologic OA at all sites. This association increased further after adjustment for height and weight differences, and was strongest for the presence of osteophytes at the TF joints (odds ratio [OR] 3.48), and was weakest for narrowing at the TF joints (OR 1.17, 95% CI 0.71-1.94). No clear risk factors were seen within the ex-athlete groups, although the tennis players tended to have more osteophytes at the TFjoints and hip, but the runners had more PF joint disease. Within the control group, a small subgroup of 22 women who reported long-term vigorous weight-bearing exercise had risks of OA similar to those of the ex-athletes. Ex-athletes had similar rates of symptom reporting but higher pain thresholds than controls, as measured by calibrated dolorimeter.Conclusion. Weight-bearing sports activity in women is associated with a 2-3-fold increased risk of radiologic OA (particularly the presence of osteophytes) of the knees and hips. The risk was similar in ex-elite athletes and in a subgroup from the general population who reported long-term sports activity, suggesting that duration rather than frequency of training is important.Osteoarthritis (OA) is one of the most common causes of disability in developed countries. An increase in the level of recreational physical activity is being widely encouraged as a major public health initiative to reduce cardiovascular disease and osteoporosis, yet the risks associated with excessive sports activity are unclear. To date, results of studies that have investigated the effects of weight-bearing exercise on the skeleton of athletes have been conflicting. Reports of negative effects have included studies of knee or hip O A in former cross country runners (1) and track athletes (2), a study of veteran Californian runners (3), and a study of knees and ankles of veteran military parachutists (4). Reports of positive effects have included a study from Finland of male ex-runners with OA (5), a recent record linkage study of male Finnish athletes showing a 2-fold risk of

Objective. To examine the role of low-grade inflammation in the etiology and progression of early osteoarthritis (OA) of the knee.Methods. We used a new, high-sensitivity, automated monoclonal antibody immunoassay for the classic acute-phase protein, C-reactive protein (CRF'), in serum. Anteroposterior radiographs of the knee with weight bearing were obtained on 845 women (ages 44-67) on entry into a population-based study of OA in Chingford, North London. In those defined radiologically as "cases," the knee radiographs were repeated after 4 years.Results. Levels of CRP were higher in 105 women with knee OA defined radiologically as KellgrenLawrence grade 2+ (median 2.4 mglliter, interquartile range [IQR] 1.0-5.1), compared with 740 women without OA (median 0.7 mglliter, IQR 0.3-1.8) (P < 0.001).Median levels of CRP were higher in the 31 women whose disease progressed at least 1 Kellgren-Lawrence grade (median 2.6 mglliter, IQR 1.9-4.6), compared with the 39 whose disease did not (median 1.3 mglliter, IQR 0.6-2.4) (P = 0.006) . The significance of these differences persisted after adjustment for age, weight, height, smoking, knee pain, or injury. Classifying disease by the presence of joint space narrowing or osteophytes alone produced similar results.