Prospective X-ray densitometry and ultrasonography study of the hand bones of patients with rheumatoid arthritis of recent onset.
OBJECTIVE
Bone demineralization observed in early rheumatoid arthritis is not easily measured. To measure bone loss and to discriminate between rheumatoid arthritis and other rheumatic diseases, we used two methods: dual-energy X-ray absorptiometry and ultrasonography.


METHODS
From a population-based recruitment, 32 patients with early peripheral polyarthritis (median disease duration: 4 months) were studied. Clinical, laboratory, functional, hand-bone assessments were made at the entry an at months 6 and 12. Bone X-ray densitometry measurements were made on 16 areas of the hand. Speed of sound was measured across the proximal phalanges of the four fingers. X-rays of both hands were scored according to the modified Sharp's score. At 12 months, patients were classified as rheumatoid arthritis (N = 15; 9 F) or as other rheumatic diseases.


RESULTS
We found: 1) significantly decreased bone mineral density (BMD) of the whole hand, in the rheumatoid arthritis group versus the other rheumatic diseases group, at 6 and 12 months (P < 0.05); 2) no significant decrease of bone mineral density (BMD) in other areas in the rheumatoid arthritis group; 3) no significant change of ultrasounds in either group; and 4) no significant correlation between the decrease of BMD in the rheumatoid arthritis group and clinical, biological or radiologic parameters, except for IFNgamma, whose production in whole blood cell culture was lower at entry in the rheumatoid arthritis group.


CONCLUSIONS
DEXA bone assessment in rheumatoid arthritis was able t detect bone loss in the whole hand at 6 months.
Daragon
A
A
Rheumatology department, INSERM U-519 and IFR 23, Centre Hospitalier Universitaire de Rouen, France. Alain.Daragon@chu-rouen.fr
Krzanowska
K
K
Vittecoq
O
O
Ménard
J F
JF
Hau
I
I
Jouen-Beades
F
F
Lesage
C
C
Bertho
J M
JM
Tron
F
F
Le Loët
X
X
D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000503:physiopathology; D001773:Blood Cells / Q000276:immunology; D015519:Bone Density; D001842:Bone and Bones / Q000000981:diagnostic imaging* / Q000378:metabolism; D002478:Cells, Cultured; D016207:Cytokines / Q000097:blood; D018450:Disease Progression; D005260:Female; D006225:Hand; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D014463:Ultrasonography
D016207:Cytokines