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Bone Density and Microarchitecture: Relationship Between Hand, Peripheral, and Axial Skeletal Sites Assessed by HR-pQCT and DXA in Rheumatoid Arthritis

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Abstract

We assessed the relationship of bone density and microarchitecture between hand, peripheral, and axial skeletal sites using high-resolution peripheral quantitative computed tomography (HR-pQCT) and dual-energy X-ray absorptiometry (DXA) in patients with rheumatoid arthritis (RA) and which factors influence these parameters. This was a cross-sectional study of 100 female patients (53.4 ± 9.3 years) with RA. HR-pQCT scans at distal radius and the second metacarpal head were performed to assess cortical and trabecular volumetric bone mineral density (vBMD) and microarchitecture. DXA scans at the hip, lumbar spine, and ultradistal radius were performed to assess areal BMD. There was significant correlation in vBMD and microarchitectural parameters between the second metacarpal head and distal radius (r = 0.201−0.628). Areal BMD at the axial skeleton was moderately associated with vBMD at the peripheral sites (r = 0.354–0.558). Factors related to disease severity/chronicity significantly correlated with vBMD and microarchitecture at the distal radius and the second metacarpal head. Factors related to disease activity were more likely to correlate with vBMD and microarchitecture at the second metacarpal head but not those at the distal radius. HR-pQCT is a promising technique that is capable of providing detailed quantitative assessment of disease-associated periarticular bone loss at both cortical and trabecular bone compartments in patients with RA. Future longitudinal studies will be needed to investigate whether assessment by HR-pQCT can be used as a marker of disease activity and a predictor of disease progression in RA.

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Acknowledgments

The authors thank Dr. Arthur L. S. Lui, Providence Foundation, for the generous financial support of this study. The authors acknowledge Ms. Betty Au for her assistance in performing the DXA scans. The funder had no role in the study design, data collection, data analysis, and production of the manuscript. The authors independently interpreted the results and made the final decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong, China

    Tracy Y. Zhu, Edmund K. Li & Lai-Shan Tam

  2. Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Hong Kong, China

    James F. Griffith

  3. Department of Orthopedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong, China

    Ling Qin, Vivian W. Y. Hung & Tsz-Ning Fong

  4. The Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Shatin, Hong Kong, China

    Anthony W. Kwok & Ping-Chung Leung

  5. Department of Medicine and Therapeutics, The Prince of Wales Hospital, 9/F Clinical Sciences Building, 30-32 Ngan Shing Street, Shatin, N.T., Hong Kong, China

    Lai-Shan Tam

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  1. Tracy Y. Zhu
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Correspondence to Lai-Shan Tam.

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Zhu, T.Y., Griffith, J.F., Qin, L. et al. Bone Density and Microarchitecture: Relationship Between Hand, Peripheral, and Axial Skeletal Sites Assessed by HR-pQCT and DXA in Rheumatoid Arthritis. Calcif Tissue Int 91, 343–355 (2012). https://doi.org/10.1007/s00223-012-9644-z

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  • DOI: https://doi.org/10.1007/s00223-012-9644-z

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