Journal of Peking University(Health Sciences) ›› 2015, Vol. 47 ›› Issue (5): 774-780. doi: 10.3969/j.issn.1671-167X.2015.05.008

• Article • Previous Articles     Next Articles

Relationship between wrist bone mineral density and synovitis, erosion by ultrasonography in female rheumatoid arthritis patients

WANG Yu, GENG Yan, DENG Xue-rong, ZHANG Zhuo-li△   

  1. (Department of Rheumatology, Peking University First Hospital, Beijing 100034, China)
  • Online:2015-10-18 Published:2015-10-18
  • Contact: ZHANG Zhuo-li E-mail:zhuoli.zhang@126.com
  • Supported by:

    Supproted by the Capital Foundation for Medical Research and Development(2011-4021-03).

Abstract:

Objective:To find the correlation of wrist bone mineral density (BMD) to wrist synovitis and erosion, by comparing wrist BMD and ultrasonography.Methods: A number of 80 female RA patients were examined by BMD measurement of the femoral neck, spine and non-dominant wrist using dual-energy X-ray absorptiometry (DXA). Synovitis of the wrist was examined by ultrasonography. The wrist joint (radiocarpal joint, dorsal midline, and carpoulnar joint) was assessed in the same side of DXA, with transverse and longitudinal scans for USGS synovial hypertrophy and proliferation, tenosynovitis,tendinitis and bone erosion. Colour and power doppler ultrasonography (PDUS) were used to sum the synovitis score.Results:We found: (1) In the study, 80 female RA patients were enrolled, the mean age was 54.6±13.3 (27.0-80.0) years, the disease duration was 48 (12-116) months, and the body Mass Index was 23.0±4.0 (14.8-31.2) kg/m2. The Wrist BMD (g/cm2) in RA significantly reduced, compared with normal controls(0.297±0.121 vs. 0.420±0.180,P<0.01). (2) The Wrist BMD (g/cm2) exceeded in early RA compared with the established RA(0.326±0.103 vs. 0.285±0.132,P<0.01); the positive rate of severe osteoporosis in wrist was lower in early RA compared with the established RA(47.8% vs. 64.9%, P<0.05); the positive rate of bone erosion in wrist by ultrasound was lower in early RA compared with the established RA (39.1% vs.  56.1%, P<0.01). (3) The wrist BMD (g/cm2) in RA with high disease activity reduced compared with moderate and low disease activity (0.267±0.140 vs. 0.280±0.126) and (0.267±0.140 vs. 0.320±0.103) respectively, P<0.05). The percentages of positive ACPA in the high and moderate disease activity groups were significantly higher than those in the remission group (85% vs. 81.8% and 92.6% vs.  81.8%, respectively). DAS28ESR was correlated with wrist BMD (r=-0.288, P<0.01). (4) A significant positive correlation was found between wrist and spine/femur BMD (r=0.634, P<0.01, r=0.795, P<0.01), and a negative correlation between wrist and disease duration and DAS28ESR (r=-0.286,r=-0.301,P<0.01). There was a highly significant positive correlation between wrist BMD and femur BMD (r=0.95,P<0.05). (5) RA patients in wrist osteoporosis group had higher RF positive rate and ACPA rate than wrist osteopenia group (75.5% vs.  55.6%,P<0.05,100% vs.  83.3%, P<0.05). The patients of BMD osteoporosis group had higher DAS28ESR compared with osteopenia group (5.3±1.8 vs.  3.7±1.5, P<0.01). The percentages of synovitis (61.5% vs.  51.7%, P<0.05), tendenitis (14.3% vs. 10.0%, P<0.05) and bone erosion (54.2% vs.  46.2%, P<0.05) in wrist by ultrasonography in osteoporosis group were higher than those of osteopenia group. (6) The wrist BMD in ne-gative bone erosion group by ultrasonography was lower than that in positive bone erosion group [(0.333±0.107) g/cm2 vs.  (0.264±0.125) g/cm2, P<0.01], also the PDUS score was higher than positive bone erosion group (4.53±1.40 vs.  2.55±2.66,P<0.01). Compared with negative bone erosion group, the patients in positive bone erosion group had longer disease duration (96.0±104.7) months vs.  (66.2±78.0) months, P<0.05), higher percentage of RF (81.0% vs.  53.8%,P<0.01), ACPA (92.7% vs. 79.5%, P<0.05). and higher DAS28ESR (5.4±1.8 vs.  4.2±2.0,P<0.05). The percentage of wrist synovitis in positive bone erosion group was higher (75.6% vs.  30.8%,P<0.01) than that of negative bone erosion group, and moreover, the percentage of severe osteoporosis in the wrist was significantly higher (75.0% vs.  46.4%, P< 0.01). (7) A stepwise multivariate linear regression model was constructed to explore the relationship between the different clinical factors studied and a low wrist BMD. Statistically significant variables were age (P=0.001), disease duration (P=0.017), DAS28ESR (P=0.021), and ACPA (P=0.05).Conclusion:This study shows a highly significant correlation between hand BMD with disease duration and disease activity, and female RA patients with high titer of ACPA have lower wrist BMD.

Key words: Arthritis, rheumatoid, Bone density, Carpal joints, Absorptiometry, photon, Ultrasonography

CLC Number: 

  •  
[1] Jinfang YUAN, Xinli WANG, Yunpu CUI, Xuemei WANG. Application of urinary luteinizing hormone in the prediction of central precocious puberty in girls [J]. Journal of Peking University (Health Sciences), 2024, 56(5): 788-793.
[2] Yan CHEN,Kuangmeng LI,Kai HONG,Shudong ZHANG,Jianxing CHENG,Zhongjie ZHENG,Wenhao TANG,Lianming ZHAO,Haitao ZHANG,Hui JIANG,Haocheng LIN. Retrospective study on the impact of penile corpus cavernosum injection test on penile vascular function [J]. Journal of Peking University (Health Sciences), 2024, 56(4): 680-686.
[3] Yue WEI,Lan YAO,Xi LU,Jun WANG,Li LIN,Kun-peng LIU. Evaluation of gastric emptying after drinking carbohydrates before cesarean section by gastric ultrasonography [J]. Journal of Peking University (Health Sciences), 2023, 55(6): 1082-1087.
[4] Yue WEI,Xi LU,Jing ZHANG,Kun-peng LIU,Yong-jun WANG,Lan YAO. Effect of preoperative carbohydrates intake on the gastric volume and the risk of reflux aspiration in patients positioning in trendelenburg undergoing gynecological laparoscopic procedures [J]. Journal of Peking University (Health Sciences), 2023, 55(5): 893-898.
[5] Qiang FU,Guan-ying GAO,Yan XU,Zhuo-hua LIN,You-jing SUN,Li-gang CUI. Comparative study of ultrasound and magnetic resonance imaging in the diagnosis of asymptomatic anterosuperior acetabular labrum tears [J]. Journal of Peking University (Health Sciences), 2023, 55(4): 665-669.
[6] Yu WANG,Hui-min ZHANG,Xue-rong DENG,Wei-wei LIU,Lu CHEN,Ning ZHAO,Xiao-hui ZHANG,Zhi-bo SONG,Yan GENG,Lan-lan JI,Yu WANG,Zhuo-li ZHANG. Diagnostic values of urinary citrate for kidney stones in patients with primary gout [J]. Journal of Peking University (Health Sciences), 2022, 54(6): 1134-1140.
[7] Hai-ying XING,Yu-hui CHEN,Ke XU,Dian-dian HUANG,Qing PENG,Ran LIU,Wei SUN,Yi-ning HUANG. Evaluation of carotid atherosclerotic plaques by vascular plaque quantification (VPQ) technology of three-dimensional ultrasonography [J]. Journal of Peking University (Health Sciences), 2022, 54(5): 991-999.
[8] YANG Guang-xin,LUAN Jing-yuan,JIA Zi-chang. Radiofrequency obliteration of varicose veins of lower extremity guided by combined venography and ultrasonography [J]. Journal of Peking University (Health Sciences), 2021, 53(2): 332-336.
[9] WANG Yu,DENG Xue-rong,JI Lan-lan,ZHANG Xiao-hui,GENG Yan,ZHANG Zhuo-li. Risk factors and diagnostic value for ultrasound-detected tendon monosodium urate crystal deposition in patients with gout [J]. Journal of Peking University (Health Sciences), 2021, 53(1): 143-149.
[10] Xiao-ran NING,Zi-qiao WANG,Shan-shan ZHANG,Xia ZHANG,Su-mei TANG,Yan-ying LIU. Application of ultrasonography scoring system in the assessment of IgG4-related sialadenitis [J]. Journal of Peking University(Health Sciences), 2019, 51(6): 1032-1035.
[11] Ning-ning LI,Li-na JI,Shuang CHAO,Ke YUAN,Hong MENG,Zhen-yu HUANG,Hua-bin ZHANG. Ultrasound screening and follow-up study of congenital anomalies of the kidney and urinary tract in neonates [J]. Journal of Peking University(Health Sciences), 2019, 51(6): 1062-1066.
[12] Peng FU,Wen CHEN,Li-gang CUI,Hui-yu GE,Shu-min WANG. Applicational value of 2017 ACR TI-RADS stratification in diagnosing thyroid nodules [J]. Journal of Peking University(Health Sciences), 2019, 51(6): 1067-1070.
[13] Peng WANG,Hua WU,Ying CHE,Dong-wei FAN,Jue LIU,Li-yuan TAO. Evaluation of screening accuracy on osteoporosis self-assessment tool for Asians and its cut-off value in healthy physical examination population [J]. Journal of Peking University(Health Sciences), 2019, 51(6): 1085-1090.
[14] Hai-hong YAO,Su-mei TANG,Zhi-min WANG,Xia ZHANG,Xu-yong CHEN,Li GAO,Jing LIU,Yi-jun DAI,Zhao-heng HU,Xue-wu ZHANG,Zhan-guo LI. Study of bone mineral density and serum bone turnover markers in newly diagnosed systemic lupus erythematosus patients [J]. Journal of Peking University(Health Sciences), 2018, 50(6): 998-1003.
[15] CUI Chen, JIANG Jie, CHEN Wen, CUI Li-gang, WANG Jin-rui. Xanthogranulonatous pyelonephritis: report of 5 cases#br# [J]. Journal of Peking University(Health Sciences), 2018, 50(4): 743-746.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!