Measurement of hand bone mineral density in early rheumatoid arthritis using dual energy X-ray absorptiometry

AimsThe earliest radiological change in rheumatoid arthritis (RA) is periarticular osteopenia, which occurs prior to the appearance of erosions and clinically apparent deformities. The aim of the study was to measure periarticular bone mineral density (BMD) in the hands of patients with early RA, using dual energy X-ray absorptiomentry (DEXA) and to correlate this with markers of disease activity and radiological progression.MethodsThe study population (n = 50) of patients with RA of ResultsHand BMD correlated strongly with sex, height, weight and lumbar and femoral neck BMD in both RA subjects and controls. Baseline hand BMD in RA subjects correlated with baseline serum C-reactive protein (r = -0.36, P = 0.01) and 12-month radiographic score (r = 0.36, P = 0.02). There were small non-significant decreases in hand, femoral neck and lumbar spine BMD over the 12-month period.ConclusionHand BMD measurement using DEXA is a reproducible, well-tolerated procedure that warrants further investigation as a component of routine assessment in early RA.Catherine L. Hill, Christopher G. Schultz, Rodney Wu, Barry E. Chatterton and Leslie G. Clelan