Measurement of hand bone mineral density in early rheumatoid arthritis using dual energy X-ray absorptiometry.
OBJECTIVE
The earliest radiological change in rheumatoid arthritis (RA) is periarticular osteopenia, which occurs prior to the appearance of erosions and clinically apparent deformities. The aim of the study was to measure periarticular bone mineral density (BMD) in the hands of patients with early RA, using dual energy X-ray absorptiomentry (DEXA) and to correlate this with markers of disease activity and radiological progression.


METHODS
The study population (n = 50) of patients with RA of < 3 years duration underwent measurement of BMD of the non-dominant hand, femoral neck and lumbar spine and clinical assessment at baseline, 6 and 12 months. Hand radiographs were performed at baseline and 12 months. Thirty age- and sex-matched controls also underwent measurement of BMD of the non-dominant hand, femoral neck and lumbar spine.


RESULTS
Hand BMD correlated strongly with sex, height, weight and lumbar and femoral neck BMD in both RA subjects and controls. Baseline hand BMD in RA subjects correlated with baseline serum C-reactive protein (r = -0.36, P = 0.01) and 12-month radiographic score (r = 0.36, P = 0.02). There were small non-significant decreases in hand, femoral neck and lumbar spine BMD over the 12-month period.


CONCLUSIONS
Hand BMD measurement using DEXA is a reproducible, well-tolerated procedure that warrants further investigation as a component of routine assessment in early RA.
Hill
Catherine L
CL
Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, Australia. Catherine.Hill@health.sa.gov.au
Schultz
Christopher G
CG
Wu
Rodney
R
Chatterton
Barry E
BE
Cleland
Leslie G
LG
D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000000981:diagnostic imaging*; D015415:Biomarkers / Q000097:blood; D015519:Bone Density; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D018450:Disease Progression; D042241:Early Diagnosis; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging; D050276:Hand Bones / Q000000981:diagnostic imaging*; D006801:Humans; D016014:Linear Models; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D013021:South Australia; D013997:Time Factors; D055815:Young Adult
D015415:Biomarkers; D002097:C-Reactive Protein