Background Rheumatoid arthritis (RA) has been associated with secondary bone loss leading to osteoporosis in 60-70% of patients. Bone loss involves both the trabecular and cortical compartment. Traditional DEXA is not sufficient to assess bone loss in various compartments, however peripheral quantitative CT (pqCT) is.
Objectives Simultaneous assessment of bone density was performed using DEXA and pqCT. Bone assessments were correlated with clinical parameters and ACPA status.
Methods pqCT assessment was performed by a Stratec XCT-2000 instrument. Altogether 48 RA female patients and 10 female healthy controls were recruited. Forearm pqCT, as well as lumbar spine and femoral neck DEXA assessments were performed. Anti-CCP was determined by a second generation ELISA.
Results The mean age of patients was 53.6±13.8 years and the mean disease duration was 13.5 years. Altogether 75% of patients were anti-CCP positive. In RA, total, cortical and trabecular attenuation, as well as bone density were decreased compared to controls as determined by pqCT (p<0.005). Total and cortical pqCT density exerted inverse correlation with age, while total, cortical and trabecular pqCT showed positive correlation with lumbar and femoral neck BMD as determined by DEXA (p<0.05). Trabecular, but not cortical pqCT density inversely correlated with anti-CCP positivity (p=0.04).
Conclusions In RA, pqCT revealed cortical and trabecular bone loss. Moreover, anti-CCP, a marker of autoimmunity and a prognostic factor associated with joint erosions, also correlate with trabecular osteoporosis. In RA, as well as primary osteoporosis, pqCT may be a useful tool to assess trabecular and cortical bone loss.
Disclosure of Interest None Declared
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