Generalised and Localised Bone Loss in Patients with Rheumatoid Arthritis

Abstract

Osteoporosis was studied in 307 patients with "definite" or "classical" rheumatoid arthritis by measurement of the clavicular cortical thickness (C.C.T.). Bone loss, as measured by this index, fell with advancing age, and was significantly greater than in non-rheumatoid control subjects matched for age and sex. Bone loss from the clavicles was not greater in patients treated with corticosteroid drugs. Loss of bone from the clavicle correlated with osteoporosis in other parts of the skeleton, as determined by the femoral and metacarpal indices. This suggests that osteoporosis in rheumatoid arthritis is a generalised phenomenon rather than a localised process secondary to adjacent joint inflammation.

Rheumatoid arthritis, corticosteroid therapy and hip fracture.

“…In the remaining 23, the major reasons for steroid use were chronic obstructive airways disease and polymyalgia rheumatica. Table 2 shows that the unadjusted risk (odds ratio) of hip fracture in patients with rheumatoid arthritis was 2-1 (95% confidence interval (CI) 1-0 to 4 7; p=006); that in subjects who were receiving steroids was [2][3][4][5][6][7] (95% CI 1-2 to 5-8; p=001). Table 2 also shows that when these risk estimates were mutually adjusted in a logistic regression model, it was apparent that the effects of rheumatoid arthritis and steroid use on hip fracture were, to a large extent, independent of each other.…”

Disease activity and disability but probably not glucocorticoid treatment predicts loss in bone mineral density in women with early rheumatoid arthritis

“…Established rheumatoid arthritis (RA) has been reported to result in an increased loss in bone mineral density (BMD) (1)(2)(3)(4). A twofold increase in the prevalence of osteoporosis was noted in female RA patients aged 20-70 years in a registry-based crosssectional study of Norwegian RA patients (5).…”

The effect of glucocorticoids on bone mass in rheumatoid arthritis patients. Influence of menopausal state

“…Rheumatoid arthritis (RA) is associated with the development of both generalized and periarticular osteoporosis (1)(2)(3)(4)(5)(6)(7)(8)(9)(10). It is uncertain whether the loss of bone mass is primarily dependent on disease activity, duration of RA, or the type of drug treatment given.…”