The British Journal of Rheumatology, Vol 36, 43-49, Copyright © 1997 by British Society for Rheumatology
JC Martin, R Munro, MK Campbell and DM Reid
The potential value of measurements of peripheral bone mass in rheumatoid
arthritis (RA) as an assessment of long-term disease activity has recently
received renewed attention. This study examines the effects of RA and
corticosteroid therapy on newer methods of measuring peripheral bone mass,
comparing the results with dual-energy X-ray absorptiometry (DXA) at axial
sites. Peripheral quantitative computed tomography of the radius,
ultrasound of the calcaneus, and DXA of the hip and spine were compared
between 29 controls and 46 women with RA of whom 25 were receiving low-dose
corticosteroid therapy. Bone mass was significantly reduced in the RA
groups for: (i) radial trabecular (36.1%) and total (15.6%) measurement
sites; (ii) calcaneal ultrasound attenuation (31.7%) and velocity (6.6%);
and (iii) femoral neck (15.4%) bone mineral density. Lumbar spine and
radial cortical measurements were not significantly affected. There were no
significant differences between the RA groups. Disease activity and
physical activity did appear to be responsible for much of the reduction in
bone mass. These results demonstrate that RA is associated with significant
bone loss at the hip, radius and calcaneus, but not at the lumbar spine. In
this small study, low-dose corticosteroids had little additional
deleterious effect.
ORIGINAL PAPERS
Effects of disease and corticosteroids on appendicular bone mass in postmenopausal women with rheumatoid arthritis: comparison with axial measurements
Department of Rheumatology, University of Aberdeen, Foresterhill.
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