Bone Mineral Density Assessment in Rheumatoid Arthritis Using Dual- Energy X- Ray Absorptiometry

Abstract

Abstract:Objectives: To determine the bone mineral density (BMD) status of our rheumatoid arthritic patients by frequency and severity and to investigate correlation between BMD status with the disease activity and duration.Patients & Methods: Eighty five Iraqi patients who had fulfilled the criteria for rheumatoid arthritis established by American College of Rheumatology (ACR) were enrolled in this study between December 2003 and April 2004. Clinical data regarding disease activity and its duration were reported. BMD measurements of the lumber spine (L1 – L4) were performed using Dual Energy X- Ray Absorptiometry (DEXA). T. scores were calculated from the BMD data.Results: A total of 85 patients were assessed, 75 were females and 10 were males with a mean age of 45 years. Twenty nine had normal BMD, Forty had osteopenia and sixteen had osteoporosis. The disease duration was classified into 3 subgroups, short (< 3 years, 23%), intermediate (3 – 6 years, 38.8%), and long (> 6 years, 37%) disease duration with a T. score means (-1.16), (- 0.99) and (- 1.05) respectively. At the time of their baseline BMD measurements, 10 patients had active disease (8 of them on prednisone 10 mg/day) with disease duration mean of ± SD (7.5 years ± 3.9) and T. score mean ± SD of (- 3.02 ± 0.6), while (75) patients whose disease was in remission (inactive) had disease duration mean ± SD of (6.08 years ± 15.6) and T. score mean ± SD of (-1.1 ± 1.3). Persistent or frank reduction of BMD measurements was documented among all patients who had ongoing active disease (p < 0.001). In spite of the importance of the longer disease duration in relation to the BMD reduction, the differences which we obtained did not achieve statistical significance (p > 0.05).Conclusion: Low bone mass density (osteopenia and osteoporosis) is common in patients with (R.A.), and it usually worsens with disease activity and severity.Key words: Osteopenia, Osteoporosis, DEXA.