Rheumatology International

, Volume 30, Issue 5, pp 605–612 | Cite as

Lower bone mineral density of forearm in postmenopausal patients with radiographic hand osteoarthritis

  • Seong-Kyu Kim
  • Sung-Hoon Park
  • Jung-Yoon ChoeEmail author
Original Article


The association between clinical parameters and forearm bone mineral density (BMD) in postmenopausal females with radiographic hand OA has not been determined. We investigated the difference in forearm BMD between radiographic hand OA and non-radiographic hand OA, and also the association between clinical parameters of patients and the level of forearm BMD. A total of 180 postmenopausal patients with hand OA were enrolled in this study. We classified them into two groups according to the Kellgren–Lawrence (K–L) radiological grade, one with radiographic hand OA (K–L grade ≥ 2) and the other with non-radiographic OA (K–L grade < 2) as controls. The number of nodal joints, swollen joints and tender joints were determined in the physical examination, and measures of BMD (g/cm2), Australian Canadian (AUSCAN) OA hand index, grip strength, pinch strength, and visual analogue scale (VAS) were also estimated. Patients with radiographic hand OA had lower distal radius BMD when compared with controls (0.35 ± 0.06 vs. 0.40 ± 0.05, P < 0.001). After adjusting for variables such as age, menopausal duration, number of nodal joints, and AUSCAN function index, the difference in BMD between the two groups was also significantly different (0.35 ± 0.04 vs. 0.38 ± 0.04, P < 0.001). For analysis of risk factors for forearm BMD in hand OA, age and K–L OA grade in total hand OA are considered risk factors, whereas age and menopause duration contribute to the forearm BMD in radiographic hand OA patients (P < 0.001, P = 0.002, respectively). The development of osteoporosis at the distal radius in radiographic hand OA is associated with older age (OR = 1.216, P = 0.002), lower BMI (OR = 0.777, P = 0.004) and lower stiffness in the AUSCAN OA index (OR = 0.505, P = 0.003). This study shows that the BMD levels of the distal radius in patients with radiographic hand OA are significantly lower when compared to those of controls. Forearm BMD levels are positively associated with age and K–L radiological grade in total hand OA, whereas age and menopausal duration are closely related with radiographic hand OA. The presence of osteoporosis in the distal radius in radiographic hand OA may be influenced by age, BMI, and stiffness on the AUSCAN index.


Osteoarthritis Hand Bone mineral density AUSCAN index Kellgren–Lawrence grade 


  1. 1.
    Felson DT (1993) The course of osteoarthritis and factors that affect it. Rheum Dis Clin North Am 19:607–615PubMedGoogle Scholar
  2. 2.
    Stewart A, Black AJ (2000) Bone mineral density in osteoarthritis. Curr Opin Rheumatol 12:464–467CrossRefPubMedGoogle Scholar
  3. 3.
    El-Sherif HE, Kamal R, Moawyah O (2008) Hand osteoarthritis and bone mineral density in postmenopausal women; clinical relevance to hand function, pain and disability. Osteoarthri Cartil 16:12–17CrossRefGoogle Scholar
  4. 4.
    Keen RW, Hart DJ, Lanchbury JS et al (1997) Association of early osteoarthritis of the knee with a Taq 1 polymorphism of the vitamin D receptor gene. Arthritis Rheum 40:1444–1449CrossRefPubMedGoogle Scholar
  5. 5.
    Kanis JA, Pitt FA (1992) Epidemiology of osteoporosis. Bone 13(Suppl 1):S7–S15CrossRefPubMedGoogle Scholar
  6. 6.
    Foss MV, Byers PD (1972) Bone density, osteoarthrosis of the hip, and fracture of the upper end of the femur. Ann Rheum Dis 31:259–264CrossRefPubMedGoogle Scholar
  7. 7.
    Hart DJ, Cronin C, Daniels M et al (2002) The relationship of bone density and fracture to incident and progressive radiographic osteoarthritis of the knee: the Chingford Study. Arthritis Rheum 46:92–99CrossRefPubMedGoogle Scholar
  8. 8.
    Zhang Y, Hannan MT, Chaisson CE et al (2000) Bone mineral density and risk of incident and progressive radiographic knee osteoarthritis in women. J Rheumatol 27:1032–1037PubMedGoogle Scholar
  9. 9.
    Sowers M, Lachance L, Jamadar D et al (1999) The association of bone mineral density and bone turnover markers with osteoarthritis of the hand and knee in pre- and perimenopausal women. Arthritis Rheum 42:483–489CrossRefPubMedGoogle Scholar
  10. 10.
    Hochberg MC, Lethbridge-Cejku M, Tobin JD (2004) Bone mineral density and osteoarthritis: data from the Baltimore Longitudinal Study of Aging. Osteoarthr Cartil 12(Suppl A):S45–S48CrossRefPubMedGoogle Scholar
  11. 11.
    Iwamoto J, Takeda T, Ichimura S (2002) Forearm bone mineral density in postmenopausal women with osteoarthritis of the knee. J Orthop Sci 7:19–25. doi: 10.1007/s776-002-8408-y CrossRefPubMedGoogle Scholar
  12. 12.
    Zoli A, Lizzio MM, Capuano A et al (2006) Osteoporosis and bone metabolism in postmenopausal women with osteoarthritis of the hand. Menopause 13:462–466. doi: 10.1097/01.gme.0000179048.08371.8e CrossRefPubMedGoogle Scholar
  13. 13.
    Schneider DL, Barrett-Connor E, Morton DJ et al (2002) Bone mineral density and clinical hand osteoarthritis in elderly men and women: the Rancho Bernardo study. J Rheumatol 29:1467–1472PubMedGoogle Scholar
  14. 14.
    Haara MM, Arokoski JP, Kröger H et al (2005) Association of radiological hand osteoarthritis with bone mineral mass: a population study. Rheumatology (Oxford) 44:1549–1554. doi: 10.1093/rheumatology/kei084 CrossRefGoogle Scholar
  15. 15.
    Hochberg MC, Lethbridge-Cejku M, Scott WW Jr et al (1994) Appendicular bone mass and osteoarthritis of the hands in women: data from the Baltimore Longitudinal Study of Aging. J Rheumatol 21:1532–1536PubMedGoogle Scholar
  16. 16.
    Altman R, Alarcon G, Appelrouth D et al (1990) The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand. Arthritis Rheum 33:1601–1610. doi: 10.1002/art.1780331101 CrossRefPubMedGoogle Scholar
  17. 17.
    Kellgren JH, Lawrence JS (1957) Radiological assessment of osteoarthritis. Ann Rheum Dis 16:494–501. doi: 10.1136/ard.16.4.494 CrossRefPubMedGoogle Scholar
  18. 18.
    Bellamy N, Campbell J, Haraoui B et al (2002) Clinimetric properties of the AUSCAN Osteoarthritis Hand Index: an evaluation of reliability, validity and responsiveness. Osteoarthr Cartil 10:863–869. doi: 10.1053/joca.2002.0838 CrossRefPubMedGoogle Scholar
  19. 19.
    Likert R (1932) A technique for measurement of attitudes. Arch Psychol 140:44–60Google Scholar
  20. 20.
    Marcelli C, Favier F, Kotzki PO et al (1995) The relationship between osteoarthritis of the hands, bone mineral density, and osteoporotic fractures in elderly women. Osteoporos Int 5:382–388. doi: 10.1007/BF01622261 CrossRefPubMedGoogle Scholar
  21. 21.
    Brownbill RA, Ilich JZ (2002) Validation of the use of the hand for estimating bone mineral density in other skeletal sites by DXA in healthy and osteoarthritic women. J Clin Densitom 5:273–282CrossRefPubMedGoogle Scholar
  22. 22.
    Beverly MC, Rider TA, Evans MJ et al (1989) Local bone mineral response to brief exercise that stresses the skeleton. BMJ 299:233–235CrossRefPubMedGoogle Scholar
  23. 23.
    Tsuji S, Tsunoda N, Yata H et al (1995) Relation between grip strength and radial bone mineral density in young athletes. Arch Phys Med Rehabil 76:234–238CrossRefPubMedGoogle Scholar
  24. 24.
    Madsen KL, Adams WC, Van Loan MD (1998) Effects of physical activity, body weight and composition, and muscular strength on bone density in young women. Med Sci Sports Exerc 30:114–120PubMedGoogle Scholar
  25. 25.
    Pocock N, Eisman J, Gwinn T et al (1989) Muscle strength, physical fitness, and weight but not age predict femoral neck bone mass. J Bone Miner Res 4:441–448CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  1. 1.Division of Rheumatology, Department of Internal MedicineCatholic University of Daegu School of MedicineDaeguSouth Korea

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