Hand bone densitometry in rheumatoid arthritis, a five year longitudinal study: an outcome measure and a prognostic marker

• Published in: Annals of the rheumatic diseases 2003-08, Vol.62 (8), p.767-770
• Main Authors: Deodhar, A A, Brabyn, J, Pande, I, Scott, D L, Woolf, A D
• Format: Article
• Language: English
• Subjects: Absorptiometry, Photon; Analysis; Antirheumatic Agents - therapeutic use; Arthritis, Rheumatoid - drug therapy; Arthritis, Rheumatoid - physiopathology; Biological and medical sciences; BMC; bone densitometry; Bone Density; bone mineral content; Bones; C-Reactive Protein - metabolism; Care and treatment; Case studies; Chest; Concise Report; Density; DHI; Disease; disease modifying antirheumatic drugs; Diseases; Diseases of the osteoarticular system; DMARDs; dual energy x ray absorptiometry; Duruoz hand index; DXA; Female; Follow-Up Studies; Hand - physiopathology; hand bone mineral content; Hands; HAQ; Health aspects; Health Assessment Questionnaire; Health risk assessment; Hospital patients; Humans; Inflammatory joint diseases; Male; Measurement techniques; Medical prognosis; Medical research; Medical sciences; Medicine, Experimental; Methodology; Methods; outcome; Prognosis; Proteins; Rheumatoid arthritis; School dropouts; Severity of Illness Index; SF-36; Short Form-36; Treatment Outcome
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/ard.62.8.767

Objective: To investigate whether hand bone mineral content (BMC) measurement is an outcome measure for RA and whether the early changes in hand BMC predict functional disability. Methods: Tender and swollen joints in hands and body, HAQ score, Larsen score on hand radiographs, serum CRP, and hand BMC measurement by DXA were studied every six months for five years in 40 patients with early RA. At the final visit, patients completed the SF-36 and Duruoz hand function questionnaires. Results: All patients completed two years and 29 completed five years’ follow up. Hand BMC worsened over the first three years (percentage loss from baseline: mean (SD) −5.5 (7.2), −7.5 (8.4), −9.8 (9.4)) and stabilised over last two years (–9.9 (8.8), −10 (7.8)). Baseline disease activity and function correlated with hand BMC loss at five years (swollen joints in hands: r=−0.38, p=0.043; swollen joints in body: r=−0.47, p=0.01; HAQ: r=−0.52, p=0.004). Percentage change in hand BMC over five years correlated with SF-36 physical function (r=0.61, p