Peripheral Bone Density in Patients with Rheumatoid Arthritis

Overview

Journal Clin Rheumatol

Publisher Springer

Specialty Rheumatology

Date 2009 Jun 17

PMID 19529880

Citations 3

Authors

Helmut Franck

Jurgen Gottwalt

Affiliations

Soon will be listed here.

Abstract

Bone loss in patients with rheumatoid arthritis (RA) varies at different skeletal sites. The aim of the study was to evaluate whether bone mineral density (BMD) of the forearm is significantly different in patients with RA and controls and may correlate to BMD or other parameters of inflammation or bone resorption. We included 421 patients (357 women: mean age 58.4 +/- 12.87 years and 64 men: mean age 56.11 +/- 12.80 years) with RA in the study. BMD values of the ultradistal forearm (0.381 +/- 0.052 g/cm(2)) and middistal forearm (0.519 +/- 0.091 g/cm(2)) were significantly (p < 0.01) lower in women with RA than controls (0.395 +/- 0.043 and 0.535 +/- 0.052 g/cm(2), respectively). In contrast, there was no difference in bone density at the lumbar spine (women 0.921 +/- 0.1570 g/cm(2), men 0.941 +/- 0.144 g/cm(2)) or hip (women 08.11 +/- 0.140 g/cm(2), men 0.895 +/- 0.143 g/cm(2)) in patients with RA in comparison to controls (lumbar spine: women 0.930 +/- 0.146 g/cm(2); men 0.960 +/- 0.146 g/cm(2); hip: women 0.820 +/- 0.122 g/cm(2); men 0.899 +/- 0.144/cm(2)). Patients with increased inflammatory activity (elevated C-reactive protein) presented with significantly lower BMD of the hip (0.7533 +/- 0.144 versus 0.825 +/- 0.138 g/cm(2)) and ultradistal forearm (0.366 +/- 0.09 versus 0.390 +/- 0.07 g/cm(2)). This was not the case for the lumbar spine. BMD of the forearm is precise and, in contrast to BMD of the lumbar spine, significantly lower in patients with RA. It is related to inflammatory activity, grip strength, and treatment with glucocorticoids in patients with RA.

Citing Articles

Revision total elbow replacement.

Chin K, Lambert S J Clin Orthop Trauma. 2021; 20:101495.

PMID: 34277345 PMC: 8271158. DOI: 10.1016/j.jcot.2021.101495.

Changes in bone density and bone turnover in patients with rheumatoid arthritis treated with rituximab, results from an exploratory, prospective study.

Wheater G, Elshahaly M, Naraghi K, Tuck S, Datta H, van Laar J PLoS One. 2018; 13(8):e0201527.

PMID: 30080871 PMC: 6078302. DOI: 10.1371/journal.pone.0201527.

Benefits of exercise in rheumatoid arthritis.

Cooney J, Law R, Matschke V, Lemmey A, Moore J, Ahmad Y J Aging Res. 2011; 2011:681640.

PMID: 21403833 PMC: 3042669. DOI: 10.4061/2011/681640.

References

Berglin E, Lorentzon R, Nordmark L, Nilsson-Sojka B, Rantapaa Dahlqvist S . Predictors of radiological progression and changes in hand bone density in early rheumatoid arthritis. Rheumatology (Oxford). 2003; 42(2):268-75. DOI: 10.1093/rheumatology/keg077. View

LeBoff M, Fuleihan G, Angell J, Chung S, Curtis K . Dual-energy x-ray absorptiometry of the forearm: reproducibility and correlation with single-photon absorptiometry. J Bone Miner Res. 1992; 7(7):841-6. DOI: 10.1002/jbmr.5650070714. View

Haugeberg G, Orstavik R, Uhlig T, Falch J, Halse J, Kvien T . Comparison of ultrasound and X-ray absorptiometry bone measurements in a case control study of female rheumatoid arthritis patients and randomly selected subjects in the population. Osteoporos Int. 2003; 14(4):312-9. DOI: 10.1007/s00198-002-1365-0. View

Lange U, Teichmann J, Muller-Ladner U, Strunk J . Increase in bone mineral density of patients with rheumatoid arthritis treated with anti-TNF-alpha antibody: a prospective open-label pilot study. Rheumatology (Oxford). 2005; 44(12):1546-8. DOI: 10.1093/rheumatology/kei082. View

Franck H, Munz M, Scherrer M . Bone mineral density of opposing hips using dual energy X-Ray absorptiometry in single-beam and fan-beam design. Calcif Tissue Int. 1998; 61(6):445-7. DOI: 10.1007/s002239900365. View

Franck H, Ittel T, Tasch O, Herborn G, Rau R . Osteocalcin in patients with rheumatoid arthritis. A one-year followup study. J Rheumatol. 1994; 21(7):1256-9. View

Shibuya K, Hagino H, Morio Y, Teshima R . Cross-sectional and longitudinal study of osteoporosis in patients with rheumatoid arthritis. Clin Rheumatol. 2002; 21(2):150-8. DOI: 10.1007/s10067-002-8274-7. View

Bottcher J, Pfeil A, Heinrich B, Lehmann G, Petrovitch A, Hansch A . Digital radiogrammetry as a new diagnostic tool for estimation of disease-related osteoporosis in rheumatoid arthritis compared with pQCT. Rheumatol Int. 2005; 25(6):457-64. DOI: 10.1007/s00296-004-0560-z. View

Slosman D, Rizzoli R, Donath A, Bonjour J . Vertebral bone mineral density measured laterally by dual-energy X-ray absorptiometry. Osteoporos Int. 1990; 1(1):23-9. DOI: 10.1007/BF01880412. View

10.

Larcos G, Wahner H . An evaluation of forearm bone mineral measurement with dual-energy X-ray absorptiometry. J Nucl Med. 1991; 32(11):2101-6. View

11.

Towheed T, Brouillard D, Yendt E, Anastassiades T . Osteoporosis in rheumatoid arthritis: findings in the metacarpal, spine, and hip and a study of the determinants of both localized and generalized osteopenia. J Rheumatol. 1995; 22(3):440-3. View

12.

Korczowska I, Olewicz-Gawlik A, Trefler J, Hrycaj P, Lacki J . Does low-dose and short-term glucocorticoids treatment increase the risk of osteoporosis in rheumatoid arthritis female patients?. Clin Rheumatol. 2007; 27(5):565-72. DOI: 10.1007/s10067-007-0747-2. View

13.

Jensen T, Hansen M, Jensen K, Podenphant J, Hansen T, Hyldstrup L . Comparison of dual X-ray absorptiometry (DXA), digital X-ray radiogrammetry (DXR), and conventional radiographs in the evaluation of osteoporosis and bone erosions in patients with rheumatoid arthritis. Scand J Rheumatol. 2005; 34(1):27-33. DOI: 10.1080/03009740510017986. View

14.

Bouxsein M, Parker R, Greenspan S . Forearm bone mineral densitometry cannot be used to monitor response to alendronate therapy in postmenopausal women. Osteoporos Int. 2000; 10(6):505-9. DOI: 10.1007/s001980050261. View

15.

Momohara S, Okamoto H, Yago T, Furuya T, Nanke Y, Kotake S . The study of bone mineral density and bone turnover markers in postmenopausal women with active rheumatoid arthritis. Mod Rheumatol. 2006; 15(6):410-4. DOI: 10.1007/s10165-005-0435-5. View

16.

Franck H, Meurer T, Hofbauer L . Evaluation of bone mineral density, hormones, biochemical markers of bone metabolism, and osteoprotegerin serum levels in patients with ankylosing spondylitis. J Rheumatol. 2004; 31(11):2236-41. View

17.

Sivas F, Barca N, Onder M, Ozoran K . The relation between joint erosion and generalized osteoporosis and disease activity in patients with rheumatoid arthritis. Rheumatol Int. 2006; 26(10):896-9. DOI: 10.1007/s00296-006-0104-9. View

18.

Guler-Yuksel M, Bijsterbosch J, Goekoop-Ruiterman Y, de Vries-Bouwstra J, Hulsmans H, de Beus W . Changes in bone mineral density in patients with recent onset, active rheumatoid arthritis. Ann Rheum Dis. 2007; 67(6):823-8. DOI: 10.1136/ard.2007.073817. View

19.

Haugen I, Slatkowsky-Christensen B, Orstavik R, Kvien T . Bone mineral density in patients with hand osteoarthritis compared to population controls and patients with rheumatoid arthritis. Ann Rheum Dis. 2007; 66(12):1594-8. PMC: 2095305. DOI: 10.1136/ard.2006.068940. View

20.

Haugeberg G, Green M, Quinn M, Marzo-Ortega H, Proudman S, Karim Z . Hand bone loss in early undifferentiated arthritis: evaluating bone mineral density loss before the development of rheumatoid arthritis. Ann Rheum Dis. 2005; 65(6):736-40. PMC: 1798164. DOI: 10.1136/ard.2005.043869. View