Hand bone mineral density is associated with both total hip and lumbar spine bone mineral density in post-menopausal women with RA

UMMS Affiliation

Department of Medicine, Division of Rheumatology

Publication Date


Document Type



Absorptiometry, Photon; Age Factors; Aged; Arthritis, Rheumatoid; Bone Density; Cross-Sectional Studies; Epidemiologic Methods; Female; Hip Joint; Humans; Lumbar Vertebrae; Metacarpal Bones; Middle Aged; Postmenopause; Time Factors


Musculoskeletal Diseases | Rheumatology | Skin and Connective Tissue Diseases | Women's Health


OBJECTIVE: RA is associated with localized bone loss in the hands, as well as generalized osteoporosis. We evaluated the relationship between hand digital X-ray radiogrammetry BMD (DXR-BMD) and total hip and lumbar spine BMD.

METHODS: We conducted a cross-sectional study of 138 post-menopausal women with RA. The DXR-BMD was calculated based on digitized hand radiographs. Measurements of the total hip and lumbar spine BMD were performed by a DXA-BMD (BMDa) scan. Patient and physician questionnaires and laboratory samples supplied information on relevant covariates. Separate multivariate linear regression models were constructed to determine the cross-sectional relationship between hand DXR-BMD (independent variable) and total hip or lumbar spine BMD (dependent variables).

RESULTS: The cohort comprised women with a median age of 61 years and RA disease duration of 13 years. Seventy-six per cent were either RF and/or anti-cyclic citrullinated peptide (anti-CCP) positive and most had moderate disease activity [median disease activity score-28 joint count (DAS28) 3.7]. Hand DXR-BMD was significantly associated with total hip BMD (beta = 0.61; P < 0.0001) and lumbar spine BMD (beta = 0.62; P < 0.0008) in adjusted models.

CONCLUSIONS: This study suggests that hand DXR-BMD is associated with both the total hip and lumbar spine BMD among post-menopausal women with RA. The relationship between bone loss in the hands and generalized osteoporosis should be further explored in longitudinal studies of patients with RA.

DOI of Published Version



Rheumatology (Oxford). 2010 Mar;49(3):513-9. doi: 10.1093/rheumatology/kep385. Epub 2009 Dec 21. Link to article on publisher's site

Journal/Book/Conference Title

Rheumatology (Oxford, England)

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Link to Article in PubMed

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