Skeletal status in rheumatoid arthritis a preliminary report

Abstract

Twenty-six women with classic or definite rheumatoid arthritis, according to the criteria of the AMERICAN RHEUMATISM ASSOCIATION, age-matched with controls were evaluated for bone mineral content and rigidity. Significant bone loss occurred in arthritics treated with corticosteroids. Bone losses at diaphyseal and metaphyseal sites were of similar magnitudesuggesting no preferential loss of trabecular bone. A significant decrease in relative ulnar rigidity was observed in patients with rheumatoid arthritis not receiving corticisteroids. An even larger decrease was noted in subjects receiving corticosteroids.Osteoporosis is commonly held to be associated with rheumatoid arthritis (1-9). Radiographic descriptions of rheumatoid arthritis frequently cite juxtaarticular and generalized bone loss as being characteristic of this disease (10-12). The etiology of the bone loss is not understood, but is attributed to multiple factors such as local inflammation, immobilization, generalized catabolic processes secondary to the disease itself, poor nutrition and the nature and duration of therapy with corticosteroids or other antiinflammatory agents. The specific role of each factor is poorly defined at present-partly be-

Bone turnover in early rheumatoid arthritis. 2. Longitudinal bone density studies.

“…In the last decade more accurate quantitative methods of assessing bone mass in vivo have become available.6 Some of these techniques have been applied in RA but generally in cross-sectional studies at appendicular sites and usually in patients with longstanding disease.3 [7][8][9][10] In the present study we have performed serial measurements of bone density in the distal radius, radius midshaft, and lumbar spine of ambulant outpatients with RA of recent onset and a group of age and sex matched controls. Since among RA patients who have not been treated with corticosteroids postmenopausal women are the group most at risk of developing osteoporosis,2 we selected for Accepted for publication 2 Bone density was measured in the dominant radius at two sites with an 'Isotom' purpose built computed tomography densitometer employing a 1251 source (29 keV, 7-4-18-5 GBq) as previously described.…”

Bone metabolism in rheumatoid arthritis compared with postmenopausal osteoporosis.

“…The results of the histomorphometric measurements were compared with results for controls of similar age and sex from the literature. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Daily protein, calcium, phosphate, and vitamin D intake were recorded by a dietician. Questionnaires were completed for average sunlight exposure and for mobility.…”

Investigation of the Vibrational Mode of a Long Bone – The Ulna

“…Using this method, Thompson [4] measured the mechanical impedance of the human ulna with the aim of determining its flexural rigidity. Other workers [5][6][7][8][9] have measured the resonant frequencies of long bones for the estimation of bone modulus of elasticity and torsional stiffness [10], some have used the impulse response method [11] in assessing bone union, and estimating bending rigidity as a measure of fracture healing [12], and some used radiation force method of focused amplitude modulated ultrasound [13] in assessing bone union. Specifically, Doherty [8] found that the resonant frequency of intact tibia was 204.9 Hz while that for an osteoporosed tibia was 170.0 Hz; whereas Collier et al [14] measured the resonant frequency of the intact tibia to be 250 Hz, in the fundamental mode of vibration.…”