Hand cortical bone mass and its associations with radiographic joint damage and fractures in 50–70 year old female patients with rheumatoid arthritis: cross sectional Oslo-Truro-Amsterdam (OSTRA) collaborative study
- G Haugeberg1,
- M C Lodder2,
- W F Lems2,
- T Uhlig1,
- R E Ørstavik1,
- B A C Dijkmans2,
- T K Kvien1,
- A D Woolf3
- 1Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
- 2Department of Rheumatology, VU University Medical Centre, Amsterdam, The Netherlands
- 3Department of Rheumatology, Royal Cornwall Hospital, Truro, UK
- Correspondence to:
Dr G Haugeberg
Department of Rheumatology, Sørlandet Hospital, N-4604 Kristiansand S, Norway;
- Accepted 1 December 2003
Objective: To investigate the relationship between hand bone mineral density (BMD) and radiographic joint damage, and between hand BMD and fractures in 50–70 year old women with longstanding RA.
Methods: Demographic, clinical data, and imaging data on hand radiographs and Genants vertebral deformity score on spine radiographs were collected from 135 women with RA of ⩾5 years, recruited from three European rheumatology clinics. Metacarpal hand BMD was measured by digital hand x ray radiogrammetry (DXR), and hip and lumbar spine BMD by dual x ray absorptiometry (DXA). Multiple regression analyses were used to examine associations between hand BMD and radiographic joint damage, and hand BMD and fractures.
Results: Hand BMD was strongly and independently associated with radiographic hand joint damage in a linear regression model adjusted for age, centre, BMI, disease duration, RF, 18 deformed joint count, ESR, and femoral neck BMD. In a multivariate logistic regression model adjusted for relevant variables, hand BMD and femoral neck BMD, but not spine BMD, were independently associated with vertebral deformities and with non-vertebral fractures.
Conclusion: BMD measured by DXR on conventional hand radiographs in patients with RA may potentially be used as an indicator of joint damage and of vertebral and non-vertebral fracture risk.
- ANOVA, analysis of variance
- BMD, bone mineral density
- BMI, body mass index
- CV, coefficient of variation
- DXA, dual x ray absorptiometry
- DXR, digital x ray radiogrammetry
- ESR, erythrocyte sedimentation rate
- RA, rheumatoid arthritis
- RF, rheumatoid factor