[The assessment of bone status in women with rheumatoid arthritis]

The aim of the study was to evaluate the skeletal status by means of several technics (bone densitometry, radiography, ultrasound) in females with rheumatoid arthritis in comparison with healthy controls. Therefore, the evaluation of the progress of osteoporosis and the assessment of clinical utility of various methods were possible. Dual X-ray absorptiometry measurements were performed at following skeletal sites: spine, proximal femur, forearm. Quantitative ultrasound measurements included calcaneus and hand phalanges, and radiography allowed for calculation of metacarpal index. Laboratory Variables include indictors of activity of disease. The progress of the disease was assessed by Steinbrocker stages, all patients completed a health assessment questionnaire (HAQ), and activity of the disease was assessed by DAS 28. In the study 104 women we evaluated (62 with rheumatoid arthritis as defined by ACR and 42 healthy controls in mean of 54.2 +/- 5.1). The mean age in patients was 56.5 +/- 9.9 years, and the mean disease duration 167.8 +/- 126.1 months. 21 (34%) were in II stage of the disease according to Steinbrocker stages. All measured skeletal variables were significantly lower in patients than in controls (p < 0.0001). The results of the study indicate that in women with rheumatoid arthritis bone status is seriously affected. All used methods allowed for comparable diagnosis of bone deterioration. A high ratio of subjects with low bone density indicates that patients with rheumatoid arthritis ought o be routinely evaluated towards osteoporosis followed by antiresorptive therapy.