Background Low Bone Mineral Density (BMD) was described in patients with inflammatory arthritis. The data on its occurrence at preliminary phase of arthritis onset is insufficient. This study looks into the prevalence of low BMD in patients with early inflammatory arthritis (EIA).
Methods We reviewed the medical records and electronic files of all patients with synovitis who attended rheumatology clinic between 1st December 2012 and 1st June 2015. Cases with features of synovitis less than two years were only included in the study. The following data was captured; demographics, time of symptom's onset, results of Dual-energy X-ray absorptiometry (DEXA) scan, and 25-hydroxyvitamin D level (ng/ml). Data are presented as the median values and interquartile range (IQR). The prevalence was described as a fraction. Mann-Whitney test was used to compare those with low BMD and those with normal BMD.
Results We identified 83 patients with inflammatory arthritis for less than two years only 31 (37.3%) patients underwent DEXA scan. 26 (83.8%) were Emirati's, 27 (87.0%) were females, and median age was 61 (IQR 57 -65 years). 9 (29%) patients had normal BMD (T-score >-1.0 S.D), 13 (41.9%) patients had osteopenia (T-score between -1.0 and -2.5 S.D), and 9 (29%) patients had osteoporosis (T-score<- 2.5 S.D). Among osteoporotic patients, 4 (12.9%) had osteoporosis at the lumbar spine only, 1 (3.2%) had osteoporosis at neck of the femur, and 4 (12.9%) patients had osteoporosis at both the lumbar spine and neck of the femur. Age was a significant predictor of low BMD in patients with EIA (Z-Score is 2.357, p-value less than 0.02). However, ethnicity, gender, time lag before the initiation of therapy, and vitamin D level did not predict the occurrence of low BMD.
Conclusions Low BMD is a frequent manifestation in patients with EIA, especially in the elder age group. Prospective studies are required to evaluate the long term significance of low BMD in EIA.
Disclosure of Interest None declared
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