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Hand bone loss measured by digital X-ray radiogrammetry is a predictor of joint damage in early rheumatoid arthritis
Scandinavian Journal of Rheumatology , 09/24/09

Forslind Ket al. – Loss of bone measured by DXR was found to be an independent predictor of radiological joint damage and may thus be an additional tool in the process of treatment decision in early RA.

Methods

166 patients with early RA
Participants were part of the Better Anti-Rheumatic FarmacOTherapy (BARFOT) low-dose prednisolone study
Randomized to treatment with 7.5 mg prednisolone daily or no prednisolone when they started with their first disease-modifying anti-rheumatic drug (DMARD) therapy
Radiographs of hands and feet taken at baseline and after 1 and 2 years and assessed by the van der Heijde modified Sharp (vdH-S) score
Hand bone density (HBD) was measured on the same radiographs by DXR
Changes in HBD and hand bone loss (HBL) calculated. HBL defined as a change in DXR bone mineral density (DXR-BMD) during the first year by more than 0.0048 g/cm2.

Results

HBL found in 64% of the patients
Patients with HBL had radiological progression significantly more often than patients without
Patients not treated with prednisolone had HBL more often than patients with treatment
In multiple regression analyses, HBL and change in DXR-BMD during first year proved to be independent predictors of radiological progression

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