Abstract
The aim of this study is to investigate the correlation between joint erosion and osteoporosis in patients with rheumatoid arthritis (RA). Fifty-one patients with RA were included for the study. Hand radiograms of all patients were evaluated by the Larsen modified Sharp and carpometacarpal ratio methods. Bone mineral density (BMD) measurements were performed at the femur, lumbar, and forearm regions. Disease activity was assessed clinically by the health assessment questionnaire (HAQ), visual analog scale, erythrocyte sedimentation rate, C-reactive protein (CRP), and the rheumatoid factor (RF). There was no statistically significant difference in terms of the BMD values at L1-4 between the patients with RA and the control group. The BMD measurements at the right forearm and the right hip were statistically significantly lower in the patient group. For radiological scoring, hand radiograms were evaluated by three different methods. There was a significant correlation between the duration of disease and the radiological evaluation methods. HAQ scores, Larsen and Sharp methods 1/3 distal and mid-distal (MID), and BMD measurements of the forearm were correlated. Moreover, 1/3 distal, MID, and ultra-distal BMD showed significant correlations with CRP levels. Radiogram continues to have an important role in determining and following-up the joint erosion seen in patients with RA. However, we believe that as establishing periarticular osteoporosis in the early term by performing BMD measurements on the forearm is correlated with disease activity, it may be useful in the early diagnosis of RA and its objective results will be efficient in predicting the progression of disease
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References
van der Heijde DMFM (1996) Plain X-rays in rheumatoid arthritis: overview of scoring methods, their reliability and applicability. Baillieres Clin Rheumatol 10:435–452
Scott DL (2000) Prognostic factors in early rheumatoid arthritis. Rheumatology 39:24–29
van der Heijde D, Dankert T, Nieman F, Rau R, Boers M (1999) Reliability and sensitivity to change of a simplification of the Sharp/van der Heijde radiological assessment in rheumatoid arthritis. Rheumatology 38:941–947
Plant MJ, Saklatvala J, Borg AA, Jones PW, Dawes PT (1994) Measurement and prediction of radiological progression in early rheumatoid arthritis. J Rheumatol 21:1808–1813
Tanaka E, Yamanaka H, Matsuda Y, Urano W, Nakajima H, Taniguchi A et al (2002) Comparison of the Rau method and the Larsen method in the evaluation of radiographic progression in early rheumatoid arthritis. J Rheumatol 29:682–687
Sharp JT, Wolfe F, Mitchell DM, Bloch DA (1991) The progression of erosion and joint space narrowing scores in rheumatoid arthritis during the first twenty-five years of disease. Arthritis Rheum 34:660–668
Larsen A, Dale K, Eek M (1977) Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference films. Acta Radiol Diagn 18:481–491
Sharp JT, Young DY, BluhmGB, Brook A, Brower AC, Corbett M et al (1985) How many joints in the hands and wrists should be included in a score of radiologic abnormalities used to assess rheumatoid arthritis? Arhritis Rheum 28:1326–1335
O’Malley M, Kenrick AJ, Sartoris DJ, Hochberg AM, Weisman MH, Ramos E et al (1989) Axial bone density in rheumatoid arthritis: comparison of dual-energy projection radiography and dual-photon absorptiometry. Radiology 170:501–505
Berglin E, Lorentzon R, Nordmark L, Nilson-Sojka B, Dahlqvist SR (2003) Predictors of radiological progression and changes in hand bone density in early rheumatoid arthritis. Rheumatology 42:268–275
Boini S, Guillemin F (2001) Radiographic scoring methods as outcome measures in rheumatoid arthritis: properties and advantages. Ann Rheum Dis 60:817–827
Devlin J, Lilley J, Gough A, Huissoon A, Holder R, Reece R et al (1996) Clinical associations of dual-energy X-ray absorptiometry measurement of hand bone mass in rheumatoid arthritis. Br J Rheumatol 35:1256–1262
Arnet FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS (1988) The American Rheumatism Association 1987 criteria for the classification of rheumatoid arthritis. Arhritis Rheum 31:315–324
Kirwan JR, Reeback JS (1986) Stanford health assessment questionnaire modified to assess disability in British patients with rheumatoid arthritis. Br J Rheumatol 25:206–209
Ardıçoğlu Ö, Özgöçmen S, Kamanlı A, Pekkutucu I (2001) Relationship between bone mineral density and radiologic scores of hands in rheumatoid arthritis. J Clin Densitom 4:263–269
Deodhar AA, Brabyn J, Jones PW, Davis MJ, Woolf AD (1995) Longitudinal study of hand bone densitometry in rheumatoid arthritis. Arhritis Rheum 38:1204–1210
d’Elia HF, Larsen A, Waltbrand E, Kvist G, Mellström D, Saxne T et al (2003) Radiographic joint destruction in postmenopausal rheumatoid arthritis is strongly associated with generalised osteoporosis. Ann Rheum Dis 62:617–623
Haugeberg G, Orstavik RE, Kvien TK (2003) Effects of rheumatoid arthritis on bone. Curr Opin Rheumatol 15:469–475
Verstraeten A, Dequeker J (1986) Vertebral and peripheral bone mineral content and fracture incidence in postmenopausal patients with rheumatoid arthritis: effect of low dose corticosteroids. Ann Rheum Dis 45:852–857
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Sivas, F., Barça, N., Önder, M. et al. The relation between joint erosion and generalized osteoporosis and disease activity in patients with rheumatoid arthritis. Rheumatol Int 26, 896–899 (2006). https://doi.org/10.1007/s00296-006-0104-9
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DOI: https://doi.org/10.1007/s00296-006-0104-9