Patients with inflammatory bowel disease (IBD) are at increased risk of developing osteopenia and osteoporosis. The aim of the study was to investigate the prevalence of decreased bone density and related risk factors in Iranian IBD patients. A total of 126 ulcerative colitis (UC) and 39 Crohn's disease (CD) patients were enrolled. Dual-energy x-ray absorptiometry technique was used to measure bone density, and blood samples were obtained to measure biochemical markers. To find predictive variables for bone mineral density (BMD), stepwise regression analysis was carried out. A total of 53 IBD patients (32.1%) had diminished bone mineral density at either lumbar spine (L1-L4) or femoral neck. Of these, 9 (5.4%) had osteoporosis; however, 44 (26.7%) were osteopenic. Femoral neck bone density was significantly decreased among CD patients (p<0.04). There was no significant difference in BMD between men and women. We have found significant differences in BMD T scores at lumbar L1-L4, L2-L4, and femoral neck in corticosteroid ever-users (p<0.002, p<0.001, p<0.003, respectively). There was no significant difference in biochemical markers between UC and CD patients, except that more CD patients were hypocalcemic (p<0.001). Stepwise regression analysis has revealed lumbar spine T score was predicted by age (p<0.0001), corticosteroid use (p<0.002), and body mass index (BMI) (p<0.005); however, femoral neck was predicted by age (p<0.0001), BMI (p<0.0001), smoking (p<0.009), and corticosteroid use (p<0.028). Low bone density in Iranian UC and CD patients is in accordance with Western societies. Treatment with corticosteroid has increased this possibility in both groups. Corticosteroid use, age, smoking, and BMI are predictive factors for low bone density.

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BD specialists could use such decision trees to reduce substantially the number of patients referred for bone densitometry and potentially save resources.

Background: Rheumatoid arthritis (RA) presents with inflammation in the joints and bony tissues around them. The trabecular bone score (TBS) is a relatively new indicator that predicts fracture risk better than bone mineral density (BMD). The aim of the current study was to measure TBSs and BMD of patients with RA referring to Resalat Hospital, Tehran. Methods: In this descriptive cross-sectional study, 129 men and women with RA entered the study through convenient sampling during 2016. TBS and BMD were measured in L1-L4. The relationships between age, sex, body mass index (BMI), duration of disease, and daily corticosteroids dose with TBS and BMD were determined by chi-square test, independent samples t test, Pearson correlation, and linear and logistic regression.

In rheumatoid arthritis, diagnosis of bone erosions and osteopenic changes in earlier stages is extremely important to the initiation of specific and more aggressive treatment to subsidize the disease, decrease morbidities, and increase patients' quality of life. In the present study, we assessed consensus rate of rheumatologists and radiologists regarding the detection of radiographic changes of hand in rheumatoid arthritis. Ninety-six adult patients with documented rheumatoid arthritis referring to our outpatient rheumatology clinic during March 2009-2010, enrolled into this cross-sectional study. Hands and wrists X-ray obtained for all patients. The films were observed by a rheumatologist and a radiologist separately, to detect focal bone erosions, periarticular osteopenic changes, and joint space losses. Agreement rates between the two specialists were assessed using the kappa test ratio. A total of 96 patients comprising 86 (89.5%) female and 10 (10.41%) male with a mean age of 48.5 ± 1.2 years (range 22-76 years old) were studied. The proportion agreement between the radiologist and rheumatologist regarding bone erosions and juxta-articular osteopenic changes was 69.7 and 84.3%, respectively. The kappa agreement coefficient for the diagnosis of bone erosions was 36% which showed significant poor agreement between two specialist (p < 0.001, proportion agreement = 69.7%). As well, the kappa of 20% for the detection of juxta-articular osteopenic changes revealed significant poor agreement between the two specialist (p < 0.047, proportion agreement = 84.3%). The results of the present study demonstrate that there is a minimal agreement between the two radiology and rheumatology specialists regarding simultaneous diagnosis of bone erosions and periarticular osteopenic changes in rheumatoid arthritis patients that emphasis requiring both specialists' X-ray report at the time of diagnosis.