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Association of bone mineral density and vertebral deformity in patients with rheumatoid arthritis

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Abstract

The aim of this study was to investigate the association of vertebral deformities developed as a result of osteoporosis in female patients with rheumatoid arthritis (RA) with bone mineral density (BMD) and disease activity parameters. In the study, 100 female patients with the diagnosis of RA and 56 healthy subjects were recruited. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and rheumatoid factor (RF) tests were performed and the number of swollen and tender joints, level of pain and health assessment questionnaire (HAQ) were recorded in order to evaluate disease activity. Anteroposterior and lateral thoracic and lumbosacral roentgenograms of all patients were taken for radiological examination and deformities of vertebrae were assessed. BMD measurements of patients were performed on vertebrae L1–4 of lumbar region and on total hip, femur neck, trochanter and Ward’s triangle of the right side. Vertebral deformity was established in 30% of RA patient group and 7.1% of control group and this was statistically significant. In the statistical analysis, no statistically significant difference was found between BMD measurements of RA and control groups. Patients with RA were divided into two subgroups with regard to using corticosteroids (CS) or not. Vertebral deformity was 32.4% in the subgroup using CS and 24.1% in the subgroup not using CS, and the difference was not statistically significant. There was a correlation between number of deformed joint and age and vertebral deformity incidence. RA is a risk factor on its own for the development of osteoporosis and vertebral deformity and this risk increases by age, excess number of deformed joints and severe course of disease. We think that precautions should be taken immediately to suppress the disease activity as well as to protect the quality and density of bone and to prevent the development of vertebral deformity and fracture while planning the treatment of patients with RA.

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References

  1. Firestein GS (2005) Rheumatoid arthritis. In: Harris ED, Budd RC, Firestein GS, Genovese MC, Sergent JS, Ruddy S, Sledge CB (eds) Kelley’s textbook of rheumatology, 7th edn, vol 2. Philadelphia, Pennsylvania, pp 996–1042

  2. Haugeberg G, Uhlig T, Falch JA et al (2000) Bone mineral density and frequency of osteoporosis in female patients with RA, results from 394 patients in Oslo County Rheumatoid Arthritis Register. Arthritis Rheum 43:522–530

    Article  PubMed  CAS  Google Scholar 

  3. Hansen M, Florescu A, Stoltenberg M et al (1996) Bone loss in rheumatoid arthritis. Scand J Rheumatol 25:367–376

    PubMed  CAS  Google Scholar 

  4. Harrison BJ, Huctchinson CE, Adams J et al (2002) Assessing periarticular bone mineral density in patients with early psöriatic arthritis or rheumatoid arthritis. Ann Rheum Dis 61:1007–1011

    Article  PubMed  CAS  Google Scholar 

  5. Laan RFJM, van Riel PLCM, van de Putte LBA (1992) Bone mass in patients with rheumatoid arthritis. Ann Rheum Dis 51:826–832

    PubMed  CAS  Google Scholar 

  6. Lems WF, Dijkmans BAC (1998) Should we look for osteoporosis in patients with rheumatoid arthritis. Ann Rheum Dis 57:325–327

    Article  PubMed  CAS  Google Scholar 

  7. Haugeberg G, Orstavik RE, Uhlig T et al (2002) Clinical decision rules in rheumatoid arthritis: do they identify patients at high risk for osteoporosis? Testing clinical criteria in a population based cohort of patients with rheumatoid arthritis recruited from the Oslo Rheumatoid Arthritis Register. Ann Rheum Dis 61:1085–1089

    Article  PubMed  CAS  Google Scholar 

  8. Orstavik RE, Haugeberg G, Mowinckel P et al (2004) Vertebral deformities in rheumatoid arthritis—a comparison to population based controls. Arch Int Med 164:420–425

    Article  Google Scholar 

  9. Peel NF, Moore DJ, Borroington NA et al (1995) Risk of vertebral fracture and relationship to bone mineral density in steroid treated rheumatoid arthritis. Ann Rheum Dis 54:801–806

    Article  PubMed  CAS  Google Scholar 

  10. Orstavik RE, Haugeberg G, Uhlig T et al (2003) Vertebral deformities in 229 female patients with RA. Associations with clinical variables and bone mineral density. Arthritis Rheum 49:355–360

    Article  PubMed  Google Scholar 

  11. Lems WF, Jahangier ZN, Raymakers J et al (1997) Methods to score vertebral deformity in patients with rheumatoid arthritis. Br J Rheum 36:220–224

    Article  CAS  Google Scholar 

  12. Arnett FC, Edworthy SM, Bloch DA et al (1998) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–320

    Article  Google Scholar 

  13. Kirwan JR, Reeback JS (1986) Stanford health assessment questionnaire modified to assess disability in British patients with rheumatoid arthritis. Br J Rheum 25:206–209

    Article  CAS  Google Scholar 

  14. Genant HK, Wu CY, van Kuijk C et al (1993) Vertebral fracture assessement using a semiquantitative technique. J Bone Min Res 8:1137–1148

    Article  CAS  Google Scholar 

  15. Ismail AA, Cooper C, Felsaberg D et al (1999) The European vertebral osteoporosis study group. The number and type of vertebral deformities. Epidemiological characteristics and relation to back pain and height loss. Osteoposis Int 9:206–213

    Article  CAS  Google Scholar 

  16. Kelly CA, Bartholomev P, Lapwoth A et al (2002) Peripheral bone density in patients with RA and factors which influence it. Eur J Int Med 13:423–427

    Article  Google Scholar 

  17. Forslind K, Keller C, Svensson B et al (2003) Reduced bone mineral density in early rheumatoid arthritis is associated with radiological joint damage at baseline and after 2 years? J Rheumatol 30:2590–2596

    PubMed  Google Scholar 

  18. Inaba M, Nuigata N, Goto H et al (2003) Preferential reductions of periarticular trabecular bone component in ultradistal radius and of calcaneous ultrasonography in early-stage RA. Osteoporosis Int 14:683–687

    Article  Google Scholar 

  19. Orstavik RE, Haugeberg G, Uhlig T et al (2004) Quantitative ultrasound and bone mineral density: discriminatory ability in patients with rheumatoid arthritis and controls with and without vertebral deformities. Ann Rheum Dis 69:945–951

    Article  Google Scholar 

  20. Stein CM, Pincus T (2001) Glucocorticoids. In Ruddy S, Harris ED, Sledge CB (eds) Kelley’s textbook of rheumatology, 6th edn, vol1. Philadelphia, Pennsylvania, pp 823–840

  21. de Nijs RNJ, Jacobs JWG, Bijlsma JWJ et al (2001) Prevalence of vertebral deformities and symptomatic vertebral fractures in corticosteroid treated patients with rheumatoid arthritis. Rheumatology 40:375–1383

    Article  Google Scholar 

  22. Haugeberg G, Orstavik RE, Kvien TK (2003) Effects of rheumatoid arthritis on bone. Curr Opin Rheumatol 15:469–475

    Article  PubMed  Google Scholar 

  23. Orstavik RE, Haugeberg G, Uhlig T et al (2005) Incidence of vertebral deformities in 255 female rheumatoid arthritis patients measured by morphometric X-ray absorptiometry. Osteoporosis Int 16:35–42

    Article  Google Scholar 

  24. Orces CH, Del Rincon I, Abel MP et al (2002) The number of deformed joints as a surrogate measure of damage in rheumatoid arthritis. Arthritis Rheum 47(1):67–72

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Clinic of Physical Medicine and Rehabilitation, Ankara Numune Education and Research Hospital, Ankara, Turkey

    Bedriye Mermerci Başkan, Filiz Sivas, Ebru Alemdaroğlu & Kürşat Özoran

  2. Clinic of Radiology, Ankara Numune Education and Research Hospital, Ankara, Turkey

    Semra Duran

  3. 86. sok. 9/16 EMEK, 6510 , Ankara, Turkey

    Bedriye Mermerci Başkan

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  1. Bedriye Mermerci Başkan
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  2. Filiz Sivas
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  3. Ebru Alemdaroğlu
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  5. Kürşat Özoran
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Correspondence to Bedriye Mermerci Başkan.

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Başkan, B.M., Sivas, F., Alemdaroğlu, E. et al. Association of bone mineral density and vertebral deformity in patients with rheumatoid arthritis . Rheumatol Int 27, 579–584 (2007). https://doi.org/10.1007/s00296-007-0323-8

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  • DOI: https://doi.org/10.1007/s00296-007-0323-8

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