Longitudinal study of hand bone densitometry in rheumatoid arthritis

Abstract

Objective. To measure hand bone mineral content (BMC) by dual x-ray absorptiometry and to seek clinical correlates in patients with rheumatoid arthritis (RA), in a prospective, longitudinal study.Methods. Eighty-one patients with non-steroidtreated RA were assessed at baseline and at month 12, for hand BMC and for disease activity and severity. Hand BMC in patients was compared with that in a control group of 95 normal volunteers, and rate of loss was compared with that in 37 controls.Results. At the initial assessment, male and female patients with RA had lower hand BMC than controls, after correction for age, height, and weight (mean reduction 7.5% in men [P = 0.0031 and 7.8% in women [P = 0.011). After 1 year, there was a further loss of hand BMC in patients (median loss 3.25% in men [P = 0.0011 and 1.46% in women [P = 0.05]), but normal controls did not have significant changes in their hand BMC. In patients with disease duration of <2 years at study entry, the parameters of disease activity improved over 1 year, but they lost significant amounts of hand BMC. Hand BMC loss correlated with baseline C-reactive protein levels. In those with RA of

Measurement of Foot Bone Mineral Density in Rheumatoid Arthritis: Its Application and Clinical Relevance

“…Generalized bone loss is an early feature of RA and its prevalence is estimated approximately two fold higher than the healthy population (11,16). This early bone loss is more pronounced in hands than in hip and lumbar spine (17)(18)(19). Periarticular bone loss has been demonstrated in certain body areas using different methods (21)(22).…”

“…Many studies (18,20,(24)(25)(26) have been published about the assessment of BMD in hand and forearm of RA patients. However to our knowledge, there is no study assessing periarticular and/or total foot BMD in RA using the DEXA method.…”

Hand bone mass in rheumatoid arthritis: A review of the literature

“…Similarly, five longitudinal studies reported hand bone loss was higher in patients with RA than in matched healthy controls or patients with other rheumatic diseases, including spondyloarthropathies or [7] CS RA: 100 F 53. In the IFX treated group hand bone loss arrested at the hip but not at the hand and lumbar spine undifferentiated arthritis [4,10,[23][24][25] .…”

“…Recently, several imaging methods have been used to assess the peripheral bone mass, including plain X-ray [5] , quantitative ultrasound (US) [6] , peripheral quantitative computed tomography (pQCT) [7] , magnetic resonance imaging [8] , digital X-ray radiogrammetry [9] and dual X-ray absorptiometry (DXA) [10] . Among them, DXA can be considered an accurate, repeatable and sensitive method to assess hand bone mineral density (BMD) in early RA [11,12] .…”

“…Five longitudinal studies reported that hand bone loss occurred early in the disease duration in patients with RA [4,10,23,24,26] . A 5-year longitudinal study of hand bone mineral content (BMC) in patients with early RA indicated that the rate of hand bone loss measured by DXA was more pronounced in the first years of disease and then slowed.…”