Vertebral Fractures in Ankylosing Spondylitis Are Associated with Lower Bone Mineral Density in Both Central and Peripheral Skeleton

From the Department of Rheumatology and Inflammation Research and the Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg; Centre for Medical Imaging and Physiology, Skåne University Hospital, and Lund University, Lund; Department of Radiology, Sahlgrenska University Hospital, Mölndal; Department of Rheumatology, Hospital of Alingsås, Alingsås; and Department of Rheumatology, Hospital of Borås, Borås, Sweden. Supported by grants from The Health and Medical Care Executive Board of the Västra Götaland, Rune and Ulla Amlövs foundation for Rheumatology Research, Gothenburg’s Association Against Rheumatism, The Medical Society of Gothenburg, and the Region Västra Götaland (agreement concerning research and education of doctors), COMBINE, Inger Bendix foundation, and the Margareta Rheuma research foundation. E. Klingberg, MD, Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg; M. Geijer, MD, PhD, Centre for Medical Imaging and Physiology, Skåne University Hospital, Lund University; J. Göthlin, MD, Professor, Department of Radiology, Sahlgrenska University Hospital/Mölndal; D. Mellström, MD, Professor; M. Lorentzon, MD, Associate Professor, Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg; E. Hilme, MD, PhD, Department of Rheumatology, Alingsås; M. Hedberg, MD, Department of Rheumatology, Borås; H. Carlsten, MD, Professor; H. Forsblad-d’Elia, MD, Associate Professor, Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg. Address correspondence to Dr. E. Klingberg, Department of Rheumatology, Sahlgrenska/SU, Gröna stråket 14, S-413 45 Gothenburg, Sweden. E-mail: Eva.Klingberg@vgregion.se Accepted for publication June 1, 2012.

From the Department of Rheumatology and Inflammation Research and the Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg; Centre for Medical Imaging and Physiology, Skåne University Hospital, and Lund University, Lund; Department of Radiology, Sahlgrenska University Hospital, Mölndal; Department of Rheumatology, Hospital of Alingsås, Alingsås; and Department of Rheumatology, Hospital of Borås, Borås, Sweden. Supported by grants from The Health and Medical Care Executive Board of the Västra Götaland, Rune and Ulla Amlövs foundation for Rheumatology Research, Gothenburg’s Association Against Rheumatism, The Medical Society of Gothenburg, and the Region Västra Götaland (agreement concerning research and education of doctors), COMBINE, Inger Bendix foundation, and the Margareta Rheuma research foundation. E. Klingberg, MD, Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg; M. Geijer, MD, PhD, Centre for Medical Imaging and Physiology, Skåne University Hospital, Lund University; J. Göthlin, MD, Professor, Department of Radiology, Sahlgrenska University Hospital/Mölndal; D. Mellström, MD, Professor; M. Lorentzon, MD, Associate Professor, Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg; E. Hilme, MD, PhD, Department of Rheumatology, Alingsås; M. Hedberg, MD, Department of Rheumatology, Borås; H. Carlsten, MD, Professor; H. Forsblad-d’Elia, MD, Associate Professor, Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg. Address correspondence to Dr. E. Klingberg, Department of Rheumatology, Sahlgrenska/SU, Gröna stråket 14, S-413 45 Gothenburg, Sweden. E-mail: Eva.Klingberg@vgregion.se Accepted for publication June 1, 2012.

From the Department of Rheumatology and Inflammation Research and the Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg; Centre for Medical Imaging and Physiology, Skåne University Hospital, and Lund University, Lund; Department of Radiology, Sahlgrenska University Hospital, Mölndal; Department of Rheumatology, Hospital of Alingsås, Alingsås; and Department of Rheumatology, Hospital of Borås, Borås, Sweden. Supported by grants from The Health and Medical Care Executive Board of the Västra Götaland, Rune and Ulla Amlövs foundation for Rheumatology Research, Gothenburg’s Association Against Rheumatism, The Medical Society of Gothenburg, and the Region Västra Götaland (agreement concerning research and education of doctors), COMBINE, Inger Bendix foundation, and the Margareta Rheuma research foundation. E. Klingberg, MD, Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg; M. Geijer, MD, PhD, Centre for Medical Imaging and Physiology, Skåne University Hospital, Lund University; J. Göthlin, MD, Professor, Department of Radiology, Sahlgrenska University Hospital/Mölndal; D. Mellström, MD, Professor; M. Lorentzon, MD, Associate Professor, Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg; E. Hilme, MD, PhD, Department of Rheumatology, Alingsås; M. Hedberg, MD, Department of Rheumatology, Borås; H. Carlsten, MD, Professor; H. Forsblad-d’Elia, MD, Associate Professor, Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg. Address correspondence to Dr. E. Klingberg, Department of Rheumatology, Sahlgrenska/SU, Gröna stråket 14, S-413 45 Gothenburg, Sweden. E-mail: Eva.Klingberg@vgregion.se Accepted for publication June 1, 2012.

From the Department of Rheumatology and Inflammation Research and the Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg; Centre for Medical Imaging and Physiology, Skåne University Hospital, and Lund University, Lund; Department of Radiology, Sahlgrenska University Hospital, Mölndal; Department of Rheumatology, Hospital of Alingsås, Alingsås; and Department of Rheumatology, Hospital of Borås, Borås, Sweden. Supported by grants from The Health and Medical Care Executive Board of the Västra Götaland, Rune and Ulla Amlövs foundation for Rheumatology Research, Gothenburg’s Association Against Rheumatism, The Medical Society of Gothenburg, and the Region Västra Götaland (agreement concerning research and education of doctors), COMBINE, Inger Bendix foundation, and the Margareta Rheuma research foundation. E. Klingberg, MD, Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg; M. Geijer, MD, PhD, Centre for Medical Imaging and Physiology, Skåne University Hospital, Lund University; J. Göthlin, MD, Professor, Department of Radiology, Sahlgrenska University Hospital/Mölndal; D. Mellström, MD, Professor; M. Lorentzon, MD, Associate Professor, Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg; E. Hilme, MD, PhD, Department of Rheumatology, Alingsås; M. Hedberg, MD, Department of Rheumatology, Borås; H. Carlsten, MD, Professor; H. Forsblad-d’Elia, MD, Associate Professor, Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg. Address correspondence to Dr. E. Klingberg, Department of Rheumatology, Sahlgrenska/SU, Gröna stråket 14, S-413 45 Gothenburg, Sweden. E-mail: Eva.Klingberg@vgregion.se Accepted for publication June 1, 2012.

From the Department of Rheumatology and Inflammation Research and the Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg; Centre for Medical Imaging and Physiology, Skåne University Hospital, and Lund University, Lund; Department of Radiology, Sahlgrenska University Hospital, Mölndal; Department of Rheumatology, Hospital of Alingsås, Alingsås; and Department of Rheumatology, Hospital of Borås, Borås, Sweden. Supported by grants from The Health and Medical Care Executive Board of the Västra Götaland, Rune and Ulla Amlövs foundation for Rheumatology Research, Gothenburg’s Association Against Rheumatism, The Medical Society of Gothenburg, and the Region Västra Götaland (agreement concerning research and education of doctors), COMBINE, Inger Bendix foundation, and the Margareta Rheuma research foundation. E. Klingberg, MD, Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg; M. Geijer, MD, PhD, Centre for Medical Imaging and Physiology, Skåne University Hospital, Lund University; J. Göthlin, MD, Professor, Department of Radiology, Sahlgrenska University Hospital/Mölndal; D. Mellström, MD, Professor; M. Lorentzon, MD, Associate Professor, Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg; E. Hilme, MD, PhD, Department of Rheumatology, Alingsås; M. Hedberg, MD, Department of Rheumatology, Borås; H. Carlsten, MD, Professor; H. Forsblad-d’Elia, MD, Associate Professor, Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg. Address correspondence to Dr. E. Klingberg, Department of Rheumatology, Sahlgrenska/SU, Gröna stråket 14, S-413 45 Gothenburg, Sweden. E-mail: Eva.Klingberg@vgregion.se Accepted for publication June 1, 2012.

From the Department of Rheumatology and Inflammation Research and the Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg; Centre for Medical Imaging and Physiology, Skåne University Hospital, and Lund University, Lund; Department of Radiology, Sahlgrenska University Hospital, Mölndal; Department of Rheumatology, Hospital of Alingsås, Alingsås; and Department of Rheumatology, Hospital of Borås, Borås, Sweden. Supported by grants from The Health and Medical Care Executive Board of the Västra Götaland, Rune and Ulla Amlövs foundation for Rheumatology Research, Gothenburg’s Association Against Rheumatism, The Medical Society of Gothenburg, and the Region Västra Götaland (agreement concerning research and education of doctors), COMBINE, Inger Bendix foundation, and the Margareta Rheuma research foundation. E. Klingberg, MD, Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg; M. Geijer, MD, PhD, Centre for Medical Imaging and Physiology, Skåne University Hospital, Lund University; J. Göthlin, MD, Professor, Department of Radiology, Sahlgrenska University Hospital/Mölndal; D. Mellström, MD, Professor; M. Lorentzon, MD, Associate Professor, Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg; E. Hilme, MD, PhD, Department of Rheumatology, Alingsås; M. Hedberg, MD, Department of Rheumatology, Borås; H. Carlsten, MD, Professor; H. Forsblad-d’Elia, MD, Associate Professor, Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg. Address correspondence to Dr. E. Klingberg, Department of Rheumatology, Sahlgrenska/SU, Gröna stråket 14, S-413 45 Gothenburg, Sweden. E-mail: Eva.Klingberg@vgregion.se Accepted for publication June 1, 2012.

From the Department of Rheumatology and Inflammation Research and the Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg; Centre for Medical Imaging and Physiology, Skåne University Hospital, and Lund University, Lund; Department of Radiology, Sahlgrenska University Hospital, Mölndal; Department of Rheumatology, Hospital of Alingsås, Alingsås; and Department of Rheumatology, Hospital of Borås, Borås, Sweden. Supported by grants from The Health and Medical Care Executive Board of the Västra Götaland, Rune and Ulla Amlövs foundation for Rheumatology Research, Gothenburg’s Association Against Rheumatism, The Medical Society of Gothenburg, and the Region Västra Götaland (agreement concerning research and education of doctors), COMBINE, Inger Bendix foundation, and the Margareta Rheuma research foundation. E. Klingberg, MD, Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg; M. Geijer, MD, PhD, Centre for Medical Imaging and Physiology, Skåne University Hospital, Lund University; J. Göthlin, MD, Professor, Department of Radiology, Sahlgrenska University Hospital/Mölndal; D. Mellström, MD, Professor; M. Lorentzon, MD, Associate Professor, Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg; E. Hilme, MD, PhD, Department of Rheumatology, Alingsås; M. Hedberg, MD, Department of Rheumatology, Borås; H. Carlsten, MD, Professor; H. Forsblad-d’Elia, MD, Associate Professor, Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg. Address correspondence to Dr. E. Klingberg, Department of Rheumatology, Sahlgrenska/SU, Gröna stråket 14, S-413 45 Gothenburg, Sweden. E-mail: Eva.Klingberg@vgregion.se Accepted for publication June 1, 2012.

From the Department of Rheumatology and Inflammation Research and the Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg; Centre for Medical Imaging and Physiology, Skåne University Hospital, and Lund University, Lund; Department of Radiology, Sahlgrenska University Hospital, Mölndal; Department of Rheumatology, Hospital of Alingsås, Alingsås; and Department of Rheumatology, Hospital of Borås, Borås, Sweden. Supported by grants from The Health and Medical Care Executive Board of the Västra Götaland, Rune and Ulla Amlövs foundation for Rheumatology Research, Gothenburg’s Association Against Rheumatism, The Medical Society of Gothenburg, and the Region Västra Götaland (agreement concerning research and education of doctors), COMBINE, Inger Bendix foundation, and the Margareta Rheuma research foundation. E. Klingberg, MD, Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg; M. Geijer, MD, PhD, Centre for Medical Imaging and Physiology, Skåne University Hospital, Lund University; J. Göthlin, MD, Professor, Department of Radiology, Sahlgrenska University Hospital/Mölndal; D. Mellström, MD, Professor; M. Lorentzon, MD, Associate Professor, Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg; E. Hilme, MD, PhD, Department of Rheumatology, Alingsås; M. Hedberg, MD, Department of Rheumatology, Borås; H. Carlsten, MD, Professor; H. Forsblad-d’Elia, MD, Associate Professor, Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg. Address correspondence to Dr. E. Klingberg, Department of Rheumatology, Sahlgrenska/SU, Gröna stråket 14, S-413 45 Gothenburg, Sweden. E-mail: Eva.Klingberg@vgregion.se Accepted for publication June 1, 2012.

From the Department of Rheumatology and Inflammation Research and the Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg; Centre for Medical Imaging and Physiology, Skåne University Hospital, and Lund University, Lund; Department of Radiology, Sahlgrenska University Hospital, Mölndal; Department of Rheumatology, Hospital of Alingsås, Alingsås; and Department of Rheumatology, Hospital of Borås, Borås, Sweden. Supported by grants from The Health and Medical Care Executive Board of the Västra Götaland, Rune and Ulla Amlövs foundation for Rheumatology Research, Gothenburg’s Association Against Rheumatism, The Medical Society of Gothenburg, and the Region Västra Götaland (agreement concerning research and education of doctors), COMBINE, Inger Bendix foundation, and the Margareta Rheuma research foundation. E. Klingberg, MD, Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg; M. Geijer, MD, PhD, Centre for Medical Imaging and Physiology, Skåne University Hospital, Lund University; J. Göthlin, MD, Professor, Department of Radiology, Sahlgrenska University Hospital/Mölndal; D. Mellström, MD, Professor; M. Lorentzon, MD, Associate Professor, Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg; E. Hilme, MD, PhD, Department of Rheumatology, Alingsås; M. Hedberg, MD, Department of Rheumatology, Borås; H. Carlsten, MD, Professor; H. Forsblad-d’Elia, MD, Associate Professor, Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg. Address correspondence to Dr. E. Klingberg, Department of Rheumatology, Sahlgrenska/SU, Gröna stråket 14, S-413 45 Gothenburg, Sweden. E-mail: Eva.Klingberg@vgregion.se Accepted for publication June 1, 2012.