Concise report
Value of clinical factors in selecting postmenopausal women with
rheumatoid arthritis for bone densitometry
J M Nolla, J Fiter, C Gómez-Vaquero, J J Alegre, J Valverde, D Roig-Escofet
Rheumatology
Department, Ciutat Sanitària i Universitària de Bellvitge,
L'Hospitalet, Barcelona, Spain
Correspondence to: Dr J M Nolla, Rheumatology Department (Pl 10-2), Ciutat Sanitària i Universitària de Bellvitge, Feixa Llarga s/n, 08907 L'Hospitalet (Barcelona), Spain 28634apj{at}comb.es
Accepted for publication 4 January
2001
OBJECTIVE
Criteria to
decide which patients with rheumatoid arthritis (RA) should be examined
by dual energy x ray absorptiometry (DXA) are currently not available. The rheumatologists from Amsterdam have
proposed preliminary criteria based on clinical risk factors (age,
disease activity, and functional status). These criteria are
preliminary and not widely accepted but might be helpful in practice.
The value of the proposal in a group of Spanish postmenopausal women
with RA is analysed.
METHODSDXA (lumbar
spine and femoral neck) was performed in 128 patients recruited from a
clinical setting, and the proposed criteria were applied. T and Z
scores were established for a Spanish reference population.
RESULTSThe mean (SD)
age of the patients was 61.3 (10.7) and mean duration of the
postmenopausal period 14.5 (10.1) years. Mean duration of RA was 13.7 (7.7) years. Mean C reactive protein was 22 (21) mg/l; mean erythrocyte
sedimentation rate 26 (18) mm/1st h; and mean Health Assessment
Questionnaire score 1.25 (0.79). Ninety (70%) patients fulfilled the
proposed criteria. Their sensitivity for the diagnosis of osteoporosis
(T score 
2.5 SD) was 86% and their specificity, 43%. Positive
predictive value was 54% and negative predictive value, 79%.
CONCLUSIONSThe
proposed criteria seem a good screening method for the selection of
those patients with RA whose bone mineral density should be assessed as
the sensitivity and negative predictive value are acceptable.
© 2001 by Annals of the Rheumatic Diseases
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This article has been cited by other articles:
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(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
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