RT Journal Article SR Electronic T1 Prevalence of Vertebral Compression Fractures and Associated Factors in Children and Adolescents with Severe Juvenile Idiopathic Arthritis JF The Journal of Rheumatology JO J Rheumatol FD The Journal of Rheumatology SP 365 OP 373 DO 10.3899/jrheum.110305 VO 39 IS 2 A1 KATI P. MARKULA-PATJAS A1 HELENA L. VALTA A1 LIISA I. KERTTULA A1 IRMA H. SOINI A1 VISA E.A. HONKANEN A1 SANNA-MARIA TOIVIAINEN-SALO A1 OUTI M. MÄKITIE YR 2012 UL http://www.jrheum.org/content/39/2/365.abstract AB Objective. Vertebral fractures occur in patients with juvenile idiopathic arthritis (JIA), but data on their frequency and causes are scarce. Our cross-sectional study evaluated prevalence of compression fractures and associated factors in a high-risk pediatric population with severe JIA. Methods. Children and adolescents with a history of treatment-resistant polyarticular-course JIA for ≥ 5 years or systemic arthritis for ≥ 3 years were recruited. Clinical examination, dietary recall, laboratory measurements, bone mineral density (BMD) measurement by dual-energy X-ray absorptiometry, and spinal radiography were performed. Results. Our study included 50 patients (41 girls), of whom 6 (12%) had systemic arthritis, with a median age of 14.8 years (range 7.0–18.7 yrs) and median disease duration of 10.2 years (range 3.9–16.8 years). Ninety-four percent had used systemic glucocorticoids (GC); the median total duration of GC treatment was 7.1 years (range 0–15.5 yrs). The median weight-adjusted cumulative GC dose for the preceding 3 years was 72 mg/kg (range 0–911 mg/kg). The median bone age-corrected lumbar spine and whole-body areal BMD Z-scores were −0.8 and −1.0, respectively. Twenty-two percent had vertebral fractures, mostly thoracic. Compression fractures were associated with high disease activity, high body mass index (BMI), and high recent cumulative GC dose, but not with disease duration or BMD. Thirty percent had sustained at least 1 peripheral low energy fracture. Twenty-six percent were deemed to have significantly compromised bone health. Conclusion. Severe JIA is associated with a significant risk of vertebral compression fractures. Associated factors include high disease activity, high BMI, and high recent GC exposure. Further studies are needed to establish optimal prevention and treatment guidelines.