Rheumatoid arthritis(RA) is a common chronic inflammatory disease and periarticular osteoporosis or osteopenia of the inflamed hand joints is an early feature of RA Quantitative measurement of hand bone loss may be an...Rheumatoid arthritis(RA) is a common chronic inflammatory disease and periarticular osteoporosis or osteopenia of the inflamed hand joints is an early feature of RA Quantitative measurement of hand bone loss may be an outcome measure for the detection of joint destruction and disease progression in early RA. This systematic review examines the published literature reporting hand bone mass in patients with RA, particularly those using the dual X-ray absorptiometry(DXA) methods The majority of the studies reported that hand bone loss is associated with disease activity, functional statusand radiological progression in early RA. Quantitative measurement of hand bone mineral density by DXA may be a useful and practical outcome measure in RA and may be predictive for radiographic progression or functional status in patients with early RA.展开更多
Background Recent studies suggest that bone marrow adipose tissue might play a role in the pathogenesis of osteoporosis. There are inconsistent findings on the relationship among marrow fat content, bone mineral densi...Background Recent studies suggest that bone marrow adipose tissue might play a role in the pathogenesis of osteoporosis. There are inconsistent findings on the relationship among marrow fat content, bone mineral density and apparent diffusion coefficient （ADC）. This study aimed to prospectively explore the efficacy of MR spectroscopy （MRS） and diffusion-weighted MR imaging （DWl） in detecting vertebral marrow changes in postmenopausal women with varying bone densities. Methods Both MRS and DWl of the lumber spine were performed in 102 postmenopausal women （mean age, （67.3±6.5） years; range, 55-83 years）, who underwent dual X-ray absorptiometry. Marrow fat content and ADC were compared and correlated among three groups： 24 with normal bone density, 31 with osteopenia and 47 with osteoporosis. Results Vertebral marrow fat content was significantly increased in the osteoporotic group （（65.60±7.68）%, P 〈0.001） and the osteopenic group （（57.68±6.45）%, P 〈0.001）, when compared with the normal bone density group （（51.67±3.27）%）. ADC values were significantly decreased in the osteoporotic group （（0.39±0.03）×10^-3mm^2/s, P 〈0.001） and in the osteopenic group （（0.42±0.02）×10^-3mm^2/s, P 〈0.001）, when compared with the normal bone density group （（0.47±0.03）×10^-3mm^2/s）. The marrow fat content negatively correlated with both bone density （r=-0.731, P 〈0.001） and marrow ADC （r=-0.572, P 〈0.001）. The bone density positively correlated with the ADC values （r=0.802, P 〈0.001）. Conclusions Postmenopausal women experience a corresponding increase in vertebral marrow fat content as the bone density decreases. Marrow fat content and ADC correlate to the bone density. MRS and DWl may indirectly assess the early bone marrow changes in postmenopausal women.展开更多
AIM: To review the published literature reporting bone loss in patients with axial spondyloarthritis(SpA) particularly those studies using dual X-ray absorptiometry(DXA) methods. METHODS: This literature review examin...AIM: To review the published literature reporting bone loss in patients with axial spondyloarthritis(SpA) particularly those studies using dual X-ray absorptiometry(DXA) methods. METHODS: This literature review examines the reported bone mass in patients with ax-SpA, particularly those using the DXA methods. The MEDLINE, Web of Science and Scopus databases were searched for relevant articles published between September 1992 and November 2013. Some of used search terms were ankylosing spondylitis(AS), SpA, spondyloarthropathy, bone loss, bone mass, osteopenia, bone mineraldensity, osteoporosis(OP), densitometry. Studies in which bone loss was investigated by using DXA in patients with Sp A were eligible. Each article was reviewed and the key elements were noted.RESULTS: There were 286 hits on MEDLINE, 200 on Web of Science and 476 on Scopus. After applying inclusion and exclusion criteria, we identified 55 articles in our systematic search. The sample size of the studies varied from 14 to 332 patients with SpA. The reported age range varied from 25 to 56 years in the reviewed studies. The symptom duration of patients with axS pA varied from 1.6 to 49 years. There were more males than females in these studies. Most of the recruited females were premenopausal women. Reported HLA-B27 positivity changed between 19% to 95%. The prevalence of OP and osteopenia in patients with Sp A varied from 3%-47% to 5%-88%, respectively, in the included studies. In particular, the prevalence of OP and osteopenia ranged from 2.0%-47.0% and 5.0%-78.3%, respectively, in patients with AS. There are conflicting results regarding the relationship among disease activity, acute phase response and bone mass. Some studies suggest good correlation of bone mass with disease activity and acute phase reactants.CONCLUSION: Bone loss may be determined in patients with ax Sp A at the lumbar spine or proximal femur even in the early phase of the disease and may be associated with inflammation(bone marrow edema) at the vertebral colon.展开更多
AIM To evaluate the power of six osteoporosis-screening instruments in women in a Mediterranean country.METHODS Data concerning several osteoporosis risk factors were prospectively collected from 1000 postmenopausal w...AIM To evaluate the power of six osteoporosis-screening instruments in women in a Mediterranean country.METHODS Data concerning several osteoporosis risk factors were prospectively collected from 1000 postmenopausal women aged 42-87 years who underwent dual-energy X-ray absorptiometry(DEXA) screening. Six osteoporosis risk factor screening tools were applied to this sample to evaluate their performance and choose the most appropriate tool for the study population.RESULTS The most important screening tool for osteoporosis status was the Simple Calculated Osteoporosis Risk Estimation, which had an area under the curve(AUC)of 0.678, a sensitivity of 72%, and a specificity of 72%, with a cut-off point of 20.75. The most important screening tool for osteoporosis risk was the Osteoporosis Self-assessment Tool, which had an AUC of 0.643, a sensitivity of 77%, and a specificity of 46%,with a cut-off point of-2.9.CONCLUSION Some commonly used clinical risk instruments demonstrate high sensitivity for distinguishing individuals with DEXA-ascertained osteoporosis or reduced bone mineral density.展开更多
文摘Rheumatoid arthritis(RA) is a common chronic inflammatory disease and periarticular osteoporosis or osteopenia of the inflamed hand joints is an early feature of RA Quantitative measurement of hand bone loss may be an outcome measure for the detection of joint destruction and disease progression in early RA. This systematic review examines the published literature reporting hand bone mass in patients with RA, particularly those using the dual X-ray absorptiometry(DXA) methods The majority of the studies reported that hand bone loss is associated with disease activity, functional statusand radiological progression in early RA. Quantitative measurement of hand bone mineral density by DXA may be a useful and practical outcome measure in RA and may be predictive for radiographic progression or functional status in patients with early RA.
文摘Background Recent studies suggest that bone marrow adipose tissue might play a role in the pathogenesis of osteoporosis. There are inconsistent findings on the relationship among marrow fat content, bone mineral density and apparent diffusion coefficient （ADC）. This study aimed to prospectively explore the efficacy of MR spectroscopy （MRS） and diffusion-weighted MR imaging （DWl） in detecting vertebral marrow changes in postmenopausal women with varying bone densities. Methods Both MRS and DWl of the lumber spine were performed in 102 postmenopausal women （mean age, （67.3±6.5） years; range, 55-83 years）, who underwent dual X-ray absorptiometry. Marrow fat content and ADC were compared and correlated among three groups： 24 with normal bone density, 31 with osteopenia and 47 with osteoporosis. Results Vertebral marrow fat content was significantly increased in the osteoporotic group （（65.60±7.68）%, P 〈0.001） and the osteopenic group （（57.68±6.45）%, P 〈0.001）, when compared with the normal bone density group （（51.67±3.27）%）. ADC values were significantly decreased in the osteoporotic group （（0.39±0.03）×10^-3mm^2/s, P 〈0.001） and in the osteopenic group （（0.42±0.02）×10^-3mm^2/s, P 〈0.001）, when compared with the normal bone density group （（0.47±0.03）×10^-3mm^2/s）. The marrow fat content negatively correlated with both bone density （r=-0.731, P 〈0.001） and marrow ADC （r=-0.572, P 〈0.001）. The bone density positively correlated with the ADC values （r=0.802, P 〈0.001）. Conclusions Postmenopausal women experience a corresponding increase in vertebral marrow fat content as the bone density decreases. Marrow fat content and ADC correlate to the bone density. MRS and DWl may indirectly assess the early bone marrow changes in postmenopausal women.
文摘AIM: To review the published literature reporting bone loss in patients with axial spondyloarthritis(SpA) particularly those studies using dual X-ray absorptiometry(DXA) methods. METHODS: This literature review examines the reported bone mass in patients with ax-SpA, particularly those using the DXA methods. The MEDLINE, Web of Science and Scopus databases were searched for relevant articles published between September 1992 and November 2013. Some of used search terms were ankylosing spondylitis(AS), SpA, spondyloarthropathy, bone loss, bone mass, osteopenia, bone mineraldensity, osteoporosis(OP), densitometry. Studies in which bone loss was investigated by using DXA in patients with Sp A were eligible. Each article was reviewed and the key elements were noted.RESULTS: There were 286 hits on MEDLINE, 200 on Web of Science and 476 on Scopus. After applying inclusion and exclusion criteria, we identified 55 articles in our systematic search. The sample size of the studies varied from 14 to 332 patients with SpA. The reported age range varied from 25 to 56 years in the reviewed studies. The symptom duration of patients with axS pA varied from 1.6 to 49 years. There were more males than females in these studies. Most of the recruited females were premenopausal women. Reported HLA-B27 positivity changed between 19% to 95%. The prevalence of OP and osteopenia in patients with Sp A varied from 3%-47% to 5%-88%, respectively, in the included studies. In particular, the prevalence of OP and osteopenia ranged from 2.0%-47.0% and 5.0%-78.3%, respectively, in patients with AS. There are conflicting results regarding the relationship among disease activity, acute phase response and bone mass. Some studies suggest good correlation of bone mass with disease activity and acute phase reactants.CONCLUSION: Bone loss may be determined in patients with ax Sp A at the lumbar spine or proximal femur even in the early phase of the disease and may be associated with inflammation(bone marrow edema) at the vertebral colon.
文摘AIM To evaluate the power of six osteoporosis-screening instruments in women in a Mediterranean country.METHODS Data concerning several osteoporosis risk factors were prospectively collected from 1000 postmenopausal women aged 42-87 years who underwent dual-energy X-ray absorptiometry(DEXA) screening. Six osteoporosis risk factor screening tools were applied to this sample to evaluate their performance and choose the most appropriate tool for the study population.RESULTS The most important screening tool for osteoporosis status was the Simple Calculated Osteoporosis Risk Estimation, which had an area under the curve(AUC)of 0.678, a sensitivity of 72%, and a specificity of 72%, with a cut-off point of 20.75. The most important screening tool for osteoporosis risk was the Osteoporosis Self-assessment Tool, which had an AUC of 0.643, a sensitivity of 77%, and a specificity of 46%,with a cut-off point of-2.9.CONCLUSION Some commonly used clinical risk instruments demonstrate high sensitivity for distinguishing individuals with DEXA-ascertained osteoporosis or reduced bone mineral density.
