Interrelationship Between Radiographic Findings of Hands and Bone Mineral Density in Patients With Rheumatoid Arthritis

Abstract

Introduction: Rheumatoid arthritis (RA) is the most common autoimmune joint disease. Osteoporosis is a well-known consequence of RA. Objective: The aim of the present study was to determine the interrelationship between radiographic findings and bone mineral density (BMD) in patients with RA. Methods: 70 patients with established RA (according to 1987 ACR criteria) were included in a cross-sectional study. BMD at lumbar vertebrae and hip were measured using DEXA machine. Plain radiographs of both hands of all patients were examined and scored according to the Larsen scoring system. Results: Sixty-five females (92.9%) and five males (7.1%) enrolled in the study. Mean of T-score in these patients was -1.06 in femoral region and -1.56 in lumbar regions. According to lumbar T-score, 50% of patients who were graded in group C Larson score (grade 4, 5) had osteoporosis and 3.33% of patients in this group had osteopenia. A high radiologic Larson score was associated with low BMD at hip and lumbar regions. Age was positively associated with low BMD. Conclusion: Higher radiologic Larson score was associated with reduced BMD in our RA patients. Because of high prevalence of osteopenia in group B (grade 2, 3 Larson score), we suggest routine bone densitometry in this group and taking into consideration anti-resorptive therapy. However, more studies are required to establish and confirm the results.

Keywords

• Rheumatoid arthritis
• Bone Mineral Density
• Hand radiography
• Larson Score.