Risk of vertebral fracture and relationship to bone mineral density in steroid treated rheumatoid arthritis.
OBJECTIVE
To determine the prevalence of vertebral fracture in postmenopausal women with steroid treated rheumatoid arthritis (RA), and whether the risk of vertebral fracture could be predicted from measurements of bone mineral density (BMD).


METHODS
Vertebral deformities were defined from spine radiographs in 76 postmenopausal women with steroid treated RA (aged 50-79 years) and 347 age matched women from a population based group, using a morphometric technique. Lumbar spine (LS) BMD was measured by dual energy x ray absorptiometry.


RESULTS
The odds ratio for vertebral fracture in the women with RA was 6.2 (95% confidence interval 3.2 to 12.3). The decrease in LS-BMD was less than expected for the observed prevalence of vertebral fracture and, among the women with RA, LS-BMD was not lower in those with vertebral fractures.


CONCLUSIONS
We conclude that patients with steroid treated RA may have abnormal bone quality, and that LS-BMD cannot be used to predict the risk of vertebral fracture in these patients.
D000368:Aged; D000893:Anti-Inflammatory Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D015519:Bone Density; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000187:drug effects / Q000293:injuries* / Q000503:physiopathology; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000209:etiology; D012307:Risk Factors; D016103:Spinal Fractures / Q000209:etiology*; D013256:Steroids
D000893:Anti-Inflammatory Agents; D013256:Steroids