Bone Abstracts

There is discussed an interrelation of BMD, progressing of erosive and destructive changes in hands and feet with development of vertebral deformations in rheumatoid arthritis (RA).

The aim: To receive data on bone mineral density (BMD), erosive and destructive changes in hands and feet and vertebral deformations in patients with RA.

Materials/methods: In this research, it was included 106 women, with RA, age 23–69 years. In all patients BMD was assessed by dual energy X-ray absorptiometry (DXA) on one Hologic «DiscoveryA» at three sites (lumbar spine (L1–L4), hip neck (HN) and distal part of forearm (DF) of nondominant hand) and was performed an X-ray morphometric analysis of vertebral bodies deformations with Genant method. The assessment of radiological signs of RA progressing was used with Sharp/van der Heijde method in 67 years. The Statistica 6.0 was used in the statistic analysis.

Results: The mean age of patients included in this research was 52.2±10.3 years, the mean age at the time of the beginning of RA was 36.9±12.1 of years, the mean duration of RA was 13.3±11.2 years. The positive rheumatoid factor was in 77 (73%) patients. 50 (47%) patients received glucocorticoids (GC). The index of erosions amount was 38.5±51.2 points, the amount of narrowed cracks 88.6±41.1 points, the total Sharp/van der Heijde score was 126.5±84.9 points. Mean BMD at L1–L4 was 0.911±0.147 g/cm², at HN – 0.705±0.117 g/cm², at DF – 0.463±0.09 g/cm². Osteoporosis (OP) at L1–L4 was revealed in 14 (15%), at HN in 10 (11%), at DF – in 32 (35%) patients. Osteopenia (Op) at L1–L4 was in 45 (48%), at HN – in 48 (53%), at DF – in 36 (39%) patients. Normal BMD was revealed at L1–L4 in 35 (37%), at HN – in 33 (36%), at DF – in 24 (26%) patients. The vertebral deformations were revealed in 24 (22%) patients. The index of vertebral deformations at thoracic site of spine was 0.77±0.08, at lumbar site – 0.79±0.06.

Conclusions: Despite the young age, patients included in research had a long duration of disease. OP at least in one department of a skeleton was revealed at a third of patients, vertebral deformations – at every fifth.