title: Periarticular osteoporosis is a prominent feature in early rheumatoid arthritis: estimation using shaft to periarticular bone mineral density ratio.
abstract: We aimed to quantify periarticular osteoporosis and investigate its significance in 45 patients with rheumatoid arthritis (RA) and 106 controls. Dual-energy X-ray absorptiometry (DXA) was used to determine the ratio of shaft to periarticular bone mineral density (BMD) as an index of periarticular demineralization. Periarticular osteoporosis was measured by conventional radiography. The BMDs of shaft and periarticular regions in eight designated areas on proximal phalanges were quantified. Clinical variables were examined to identify risk factors for periarticular osteoporosis. The assessment of periarticular osteoporosis on X-ray images reached a moderate degree of interobserver agreement among four physicians (ĸ = 0.47). For BMD quantification, we designed three types of mathematical formulae: the ratio of shaft to periarticular BMD, the mean of the ratios, and the ratio of the sums. These ratios were significantly higher in the patients with early RA (disease duration ≤ 3 yr) than in controls (P < 0.01). The findings were not as distinctive in patients with established RA. Body mass index, cumulative dose of corticosteroid, and C-terminal telopeptide were correlated with BMD ratios. Conclusively, DXA-assisted localized quantification and BMD ratio calculations are feasible for assessing periarticular demineralization. Periarticular osteoporosis is a relatively distinctive feature of early RA.
authors: Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea.
authors: Su-Jin
authors: SJ
authors: Moon
authors: Inhye E
authors: IE
authors: Ahn
authors: Seung-Ki
authors: SK
authors: Kwok
authors: Kyung-Su
authors: KS
authors: Park
authors: Jun-Ki
authors: JK
authors: Min
authors: Sung-Hwan
authors: SH
authors: Park
authors: Ho-Youn
authors: HY
authors: Kim
authors: Ji Hyeon
authors: JH
authors: Ju
mesh_terms: D015502:Absorptiometry, Photon; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000209:etiology; D015992:Body Mass Index; D015519:Bone Density; D024042:Collagen Type I / Q000032:analysis; D005260:Female; D006801:Humans; D007596:Joints; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D010455:Peptides / Q000032:analysis; D012372:ROC Curve; D012307:Risk Factors
chemical_list: D000305:Adrenal Cortex Hormones; D024042:Collagen Type I; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide
keywords: Arthrits; Bone Density; Periarticular Osteopenia; Rheumatoid
references: Osteoporos Int. 2005 Jun;16(6):672-80
references: 15502963
references: Osteoporos Int. 2000;11(5):400-7
references: 10912841
references: Arthritis Res Ther. 2008;10(1):103
references: 18254923
references: Rheumatology (Oxford). 2011 Dec;50(12):2257-63
references: 21990370
references: Ann Rheum Dis. 2003 Aug;62(8):767-70
references: 12860734
references: Ann Rheum Dis. 2004 Oct;63(10):1331-4
references: 15361395
references: Lancet. 2008 Aug 2;372(9636):375-82
references: 18635256
references: Arthritis Rheum. 2005 Apr;52(4):1020-30
references: 15818697
references: Ann Rheum Dis. 2004 Jun;63(6):675-80
references: 15140774
references: Ann Rheum Dis. 2007 Nov;66(11):1513-7
references: 17491097
references: Clin Rheumatol. 2010 Feb;29(2):211-3
references: 19809777
references: Baillieres Clin Rheumatol. 1996 Aug;10(3):435-53
references: 8876953
references: Arch Med Res. 2005 Sep-Oct;36(5):603-6
references: 16099346
references: Ann Rheum Dis. 2009 Jul;68(7):1171-6
references: 18801760
references: Ann Rheum Dis. 2009 Mar;68(3):330-6
references: 18375540
references: Ann Rheum Dis. 2004 Jan;63(1):15-22
references: 14672886
references: Ann Rheum Dis. 1994 Oct;53(10):685-90
references: 7979583
references: Arthritis Rheum. 2004 Nov;50(11):3432-43
references: 15529377
references: AJR Am J Roentgenol. 2005 May;184(5):1391-7
references: 15855085
references: Arthritis Res Ther. 2007;9(4):R81
references: 17705865
references: Arthritis Rheum. 1994 Jul;37(7):983-91
references: 8024625