TO CORRELATE THE HAND BONE MINERAL DENSITY AND JOINT DEGRADATION IN PATIENTS WITH CHRONIC RHEUMATOID ARTHRITIS
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Abstract
In patients from Lucknow region with established rheumatoid arthritis (RA), we sought to elucidate the relationship between bone mineral density (BMD) and the modified total Sharp score of the hand. 114 individuals who had RA for more than 22 years had their hands inspected. BMD was determined by dual-energy x-ray absorptiometry for the whole hand. At the same time, the van der Heijde-modified total Sharp score (vdH-S) was estimated by radiographic analysis of the hands. Hand BMD and the hand's vdH-S had a P < 0.0001, hand BMD and the hand's erosion score had a P < 0.0001, and hand BMD and the vdH-S's joint narrowing score had a P < 0.0001. In chronic RA, there is a correlation between hand BMD and the vdH-S. When evaluating the hand's structure, the hand's BMD is crucial. Furthermore, based on the hand BMD in patients with chronic RA, we might be able to anticipate the hand's vdH-S.
References
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21. Wakefield RJ, Gibbon WW, Conaghan PG, O’Connor P, McGonagle D, Pease C, et al. The value of sonography in the detection of bone erosions in patients with rheumatoid arthritis: a comparison with conventional radiography. Arthritis Rheum 2000;43:2762-70.
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23. Gravallese EM, Goldring SR. Cellular mechanisms and the role of cytokines in bone erosions in rheumatoid arthritis. Arthritis Rheum 2000;43:2143-51.
24. Hofbauer LC, Lacey DL, Dunstan CR, Spelsberg TC, Riggs BL, Khosla S. Interleukin-1beta and tumor necrosis factor-alpha, but not interleukin-6, stimulate osteoprotegerin ligand gene expression in human osteoblastic cells. Bone 1999;25:255-9.
25. Nakashima T, Kobayashi Y, Yamasaki S, Kawakami A, Eguchi K, Sasaki H, et al. Protein expression and functional difference of membrane-bound and soluble receptor activator of NF-kappaB ligand: modulation of the expression by osteotropic factors and cytokines. Biochem Biophys Res Commun 2000;275:768-75.
26. Schett G, Redlich K, Hayer S, Zwerina J, Bolon B, Dunstan C, et al. Osteoprotegerin protects against generalized bone loss in tumor necrosis factor- transgenic mice. Arthritis Rheum 2003;48:2042-51.
27. Haugeberg G, Green MJ, Conaghan PG, et al. Hand bone densitometry: a more sensitive standard for the assessment of early bone damage in rheumatoid arthritis. Ann Rheum Dis. 2007;66:1513-1517.
2. Deodhar AA, Brabyn J, Jones PW, Davis MJ, Woolf AD. Longitudinal study of hand bone densitometry in rheumatoid arthritis. Arthritis Rheum 1995;38:1204-10.
3. Haugeberg G, Green MJ, Quinn MA, Marzo-Ortega H, Proudman S, Karim Z, et al. Hand bone loss in early undifferentiated arthritis: evaluating bone mineral density loss before the development of rheumatoid arthritis. Ann Rheum Dis 2006;65:736-40.
4. Emery P. The Dunlop-Dottridge Lecture: prognosis in inflammatory arthritis: the value of HLA genotyping and the oncological analogy. J Rheumatol 1997;24:1436-42.
5. Proudman SM, Conaghan PG, Richardson C, Griffiths B, Green MJ, McGonagle D, et al. Treatment of poor-prognosis early rheumatoid arthritis. A randomized study of treatment with methotrexate, cyclosporin A, and intraarticular corticosteroids compared with sulfasalazine alone. Arthritis Rheum 2000;43:1809-19.
6. Deodhar AA, Brabyn J, Jones PW, Davis MJ, Woolf AD. Measurement of hand bone mineral content by dual energy x-ray absorptiometry: development of the method, and its application in normal volunteers and in patients with rheumatoid arthritis. Ann Rheum Dis 1994;53:685-90.
7. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986;1:307-10.
8. Lodder MC, Lems WF, Ader HJ, Marthinsen AE, van Coeverden SC, Lips P, et al. Reproducibility of bone mineral density measurement in daily practice. Ann Rheum Dis 2004;63:285-9.
9. Ravaud P, Reny JL, Giraudeau B, Porcher R, Dougados M, Roux C. Individual smallest detectable difference in bone mineral density measurements. J Bone Miner Res 1999;14:1449-56.
10. Bruynesteyn K, Boers M, Kostense P, Van Der LS, Van Der HD. Deciding on progression of joint damage in paired films of individual patients: smallest detectable difference or change. Ann Rheum Dis 2005;64:179-82.
11. Genant HK, Block JE, Steiger P, Glueer CC, Ettinger B, Harris ST. Appropriate use of bone densitometry. Radiology 1989;170:817-22.
12. Gluer CC. Monitoring skeletal changes by radiological techniques. J Bone Miner Res 1999;14:1952-62.
13. Van Der HD. How to read radiographs according to the Sharp/van der Heijde method. J Rheumatol 1999;26:743-5.
14. Alenfeld FE, Diessel E, Brezger M, Sieper J, Felsenberg D, Braun J. Detailed analysesin periarticular osteoporosis in rheumatoid arthritis. Osteoporos Int 2000;11:400-7.
15. Paulus HE, Oh M, Sharp JT, Gold RH, Wong WK, Park GS, et al. Correlation of single time-point damage scores with observed progression of radiographic damage during the first 6 years of rheumatoid arthritis. J Rheumatol 2003;30:705-13.
16. van der Heijde D. Radiographic progression in rheumatoid arthritis: Does it reflect outcome? Does it reflect treatment? Ann Rheum Dis 2001;60(Suppl III):47-50.
17. Deodhar AA, Brabyn J, Pande I, Scott DL, Woolf AD. Hand bone densitometry in rheumatoid arthritis, a five year longitudinal study: an outcome measure and a prognostic marker. Ann Rheum Dis 2003;62:767-70.
18. Lindqvist E, Jonsson K, Saxne T, Eberhardt K. Course of radiographic damage over 10 years in a cohort with early rheumatoid arthritis. Ann Rheum Dis 2003;62:611-16.
19. Conaghan PG, O’Connor P, McGonagle D, Astin P, Wakefield RJ, Gibbon WW, et al. Elucidation of the relationship between synovitis and bone damage: a randomized magnetic resonance imaging study of individual joints in patients with early rheumatoid arthritis. Arthritis Rheum 2003;48:64-71.
20. McQueen F, Lassere M, Edmonds J, Conaghan P, Peterfy C, Bird P, et al. OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging Studies. Summary of OMERACT 6 MR Imaging Module. J Rheumatol 2003;30:1387-92.
21. Wakefield RJ, Gibbon WW, Conaghan PG, O’Connor P, McGonagle D, Pease C, et al. The value of sonography in the detection of bone erosions in patients with rheumatoid arthritis: a comparison with conventional radiography. Arthritis Rheum 2000;43:2762-70.
22. Redlich K, Hayer S, Maier A, Dunstan CR, Tohidast-Akrad M, Lang S, et al. Tumor necrosis factor alpha-mediated joint destruction is inhibited by targeting osteoclasts with osteoprotegerin. Arthritis Rheum 2002;46:785-92.
23. Gravallese EM, Goldring SR. Cellular mechanisms and the role of cytokines in bone erosions in rheumatoid arthritis. Arthritis Rheum 2000;43:2143-51.
24. Hofbauer LC, Lacey DL, Dunstan CR, Spelsberg TC, Riggs BL, Khosla S. Interleukin-1beta and tumor necrosis factor-alpha, but not interleukin-6, stimulate osteoprotegerin ligand gene expression in human osteoblastic cells. Bone 1999;25:255-9.
25. Nakashima T, Kobayashi Y, Yamasaki S, Kawakami A, Eguchi K, Sasaki H, et al. Protein expression and functional difference of membrane-bound and soluble receptor activator of NF-kappaB ligand: modulation of the expression by osteotropic factors and cytokines. Biochem Biophys Res Commun 2000;275:768-75.
26. Schett G, Redlich K, Hayer S, Zwerina J, Bolon B, Dunstan C, et al. Osteoprotegerin protects against generalized bone loss in tumor necrosis factor- transgenic mice. Arthritis Rheum 2003;48:2042-51.
27. Haugeberg G, Green MJ, Conaghan PG, et al. Hand bone densitometry: a more sensitive standard for the assessment of early bone damage in rheumatoid arthritis. Ann Rheum Dis. 2007;66:1513-1517.
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Published
Oct 21, 2008
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Singh Manvendra Pratap. (2008). TO CORRELATE THE HAND BONE MINERAL DENSITY AND JOINT DEGRADATION IN PATIENTS WITH CHRONIC RHEUMATOID ARTHRITIS. Journal of Population Therapeutics and Clinical Pharmacology, 15(3), 796-801. https://doi.org/10.53555/7vpjxe47
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Author Biography
Singh Manvendra Pratap
Assistant Professor, Department of Orthopaedics, ERA'S Lucknow Medical College and Hospital, Sarfarazganj Hardoi Raod, Lucknow-226003.
How to Cite
Singh Manvendra Pratap. (2008). TO CORRELATE THE HAND BONE MINERAL DENSITY AND JOINT DEGRADATION IN PATIENTS WITH CHRONIC RHEUMATOID ARTHRITIS. Journal of Population Therapeutics and Clinical Pharmacology, 15(3), 796-801. https://doi.org/10.53555/7vpjxe47