Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0003873 (rheumatoid arthritis)
 53,068 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The CT numbers of cortex at the level of 20 cm (CT20) and spongiosa in the lateral condyle at the level of 2 cm (CT20) proximal from the distal end of the femur, and the bone mineral density of spongiosa in the L3 body (BMD), were obtained by QCT. The study included 43 female patients with rheumatoid arthritis (RA), 71 female patients with primary osteoporosis (OP), 20 female nondialyzed patients with chronic renal failure (CRF:nonHD), 37 hemodialyzed patients (CRF:HD), including 13 parathyroidectomized patients (CRF:HD, PTX), and 10 healthy volunteers. CT20 correlated closely with age in RA. CT02 and BMD correlated closely with age in RA and OP. CT20 and CT02 correlated closely with the duration of hemodialysis in CRF:HD, but not with the duration of disease in RA. The values of CT20 and CT02 in the CRF:HD. PTX group were significantly lower than those in the other CRF groups. BMD in the RA groups was not different from that of healthy volunteers. The CT20 values of the one-third of RA patients older than 60 years were extremely low compared with those of the other two-thirds. The results indicated that BMD was useful in assessing bone mineral content in OP, but not in RA. CT02 and CT20 were useful in assessing bone mineral content in these three diseases, CT20 was especially useful for patients in the CRF:HD group and those with RA older than 60 years, but it was not useful in the CRF:nonHD group.
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PMID:[The assessment of cortical and spongy bone mineral content with quantitative computed tomography. A comparison of measurement sites in relation to certain diseases with metabolic bone disorder]. 179 54

The CT numbers of cortex at the level of 20 cm (CT20) and of spongiosa in the lateral condyle at 2 cm (CT02) proximally from the distal end of the femur, and the bone mineral density of spongiosa in L3 body (BMD), were obtained by QCT. The study included 48 patients with rheumatoid arthritis or chronic renal failure as well as 10 healthy volunteers. The relationships of CT20 vs BMD in the regions above and below a critical value of BMD were quite different from each other. Similar relationships were observed in the plot of CT20 vs CT02. The results indicated that the demineralization of cortex was much less than that of spongiosa while the mineral content of spongiosa kept higher than a critical value, but the demineralization of cortex surpassed that of spongiosa once the mineral content of spongiosa had become lower than the critical value. It is necessary to assess bone mineral content of cortex especially in patients with lingering imbalance of bone metabolism.
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PMID:[Usefulness of assessing bone mineral content of cortical bone in patients with lingering imbalance of bone metabolism]. 233 Feb 91

Rheumatoid arthritis (RA) of progressive systemic disease predisposing for osteoporosis. Inflammatory process, applied treatment as well as considerably impared efficiency of motor organ create conditions for osteoporosis. The changes of bone mineral density in RA were assessed in 50 patients treated for various form of RA, at the Rheumatological and Rehabilitation Hospital in Cracow. The age of patients ranged from 21-79 yrs: the mean age was 50 years. The group consisted of 46 (92%) females and 4 (8%) males. Apart from standard clinical examinations there was assessed in all cases mineral density in distal radius using Osteometer DTX 100. Mineral density BMD was estimated in distal and ultradistal region of radius. All patients were qualified into 4 groups depending on the stage of radiological changes according to Steinbrocker. Group I included 16%, group II-30%, group III-30%, and IV-24% of patients. Steroid therapy was applied in 20 (40%) cases. The results showed progressive decrease of mineral density BMD in distal radius in patients with advanced RA. It was also observed that in RA patients mineral density defect occurs earlier in trabecular than in cortical bone.
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PMID:[Evaluation of mineral density in the distal radius during the course of rheumatoid arthritis]. 933 81

Patients with rheumatoid arthritis (RA) develop both periarticular and generalized osteoporosis. Periarticular osteopenia in appendicular bones occurs early in the course of RA and is one of the earliest radiological signs of RA. An uncoupled state in bone resorption-formation linkage, contributes to the development of periarticular osteopenia and it might be mediated through an increased productions of cytokines and prostaglandins by synovium and bone marrow. Accordingly, early suppression of rheumatoid synovitis is necessary for the prevention of periarticular osteopenia. Generalized osteoporosis is also common in RA and leads to increased risk of fractures. Generalized osteoporosis considered to be multifactorial and factors contributing to lumbar osteoporosis might be different from those to loss of appendicular bones, such as femur and radius. Corticosteroids and menopausal state are important risk factors for lumbar osteoporosis. Rheumatoid activity and reduced physical activity are also important determinants. According to the previous studies, however, the influence of functional impairment is more prominent in the femoral BMD compared to spinal BMD. In addition to control of RA and maintenance of physical activity, hormone replacement therapy (HRT) and bisphosphonate are possible agents for the treatment of osteoporosis in RA patients, especially postmenopausal women.
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PMID:[Osteoporosis in rheumatoid arthritis]. 964 88

This study proposed an assessment of the correlation of hand bone mineral density measured by dual energy x-ray absorbtiometry (DXA) with the carpo:metacarpal (C:MC) ratio and metacarpal cortical index (CI) in patients with rheumatoid arthritis (RA). The correlation of total hand BMD, CI and C:MC ratio with BMD at other sites, the Health Assessment Questionnaire (HAQ) and Larsen scores were also examined. The hand and axial BMD of 30 female patients were also compared with 29 age-matched healthy female controls. Total hand BMD values of patients were significantly lower than the control group. There was no significant difference between groups in axial measurements. CI correlated moderately with the second metacap (II.MC) midshaft and total hand BMD. The C:MC ratio correlated with II.MC midshaft and total hand BMD. Total hand BMD correlated moderately with the AP spine (L2-L4) and femoral neck BMD. Larsen scores showed weak negative correlation with II.MC midshaft BMD and CI. Grip strength correlated weakly only with total hand BMD. The results indicated that CI may reflect cortical bone mass of the hand accurately and did not predict bone density of the spine or hip in patients with RA. The C:MC ratio is a useful method for evaluating progression of wrist involvement and may be related to the loss of hand bone mineral density associated with disease process.
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PMID:Correlation of hand bone mineral density with the metacarpal cortical index and carpo:metacarpal ratio in patients with rheumatoid arthritis. 1056 60

Corticosteroid-induced osteoporosis is a common occurrence among several different patient populations, including individuals undergoing therapy for rheumatoid arthritis, temporal arteritis, polymyalgia rheumatica, chronic lung disease, asthma and organ transplantation. The clinical trial data reviewed here demonstrate that bisphosphonate therapy can reverse, at least in part, established corticosteroid-induced osteoporosis, increase BMD, and prevent the development of new fractures. The consistency of results, with varying treatment regimens and in slightly different patient populations, provides strong support for the generalizability of these findings and for the use of bisphosphonates in corticosteroid-induced osteoporosis. These results are consistent with the findings from a recent meta-analysis, which reviewed data from 13 controlled clinical trials of bisphosphonate use in corticosteroid-induced osteoporosis. In that analysis, 1 year of bisphosphonate therapy produced a significant increase in BMD at the lumbar spine (average difference in BMD between treated and control groups of 4.0%) and femoral neck (average BMD difference of 2.1% between treated and control patients). Bisphosphonate therapy, therefore, appears to be an effective, well-tolerated means of reducing the risk of bone fractures among patients treated with corticosteroids.
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PMID:Bisphosphonates for the prevention and treatment of corticosteroid-induced osteoporosis. 1184 38

Osteoporosis is a common complication of AS, with an incidence between 18.7% and 62%. The prevalence of osteoporosis is greater in males, and increases with increasing patient age and disease duration. Osteoporosis is also more common in patients with syndesmophytes, cervical fusion, and peripheral joint involvement. These variables are not all independent, as they may be indicators of disease duration. Osteoporosis in patients with AS is largely confined to the axial skeleton, in contrast to the pattern of osteoporosis seen in rheumatoid arthritis. BMD at the lumbar spine and femoral neck may be severely reduced, while most studies indicate that carpal and radial BMD remain within normal limits. The development of syndesmophytes in late AS can lead to difficulties in the use of DEXA scanning to determine lumbar BMD, as the extraspinal bone may obscure osteoporotic vertebrae. Under these circumstances more accurate assessment of lumbar BMD, and one that correlates better with femoral neck BMD, may be obtained by quantitative CT scanning or DEXA scanning of the lateral aspect of the L3 vertebra. Osteoporosis in AS significantly increases the risk of vertebral compression fractures within 5 years of the diagnosis of AS. The risk of a vertebral compression fracture occurring over a 30 year period following the diagnosis of AS is 14%, compared to 3.4% for population controls. In patients with vertebral osteoporosis relatively minor trauma, such as slipping, can lead to spinal fracture and dislocatior with subsequent damage to the spinal cord. There is a higher incidence of spinal cord injury following spinal fracture dislocations in patients with AS, and the resulting neurological deficit can range from mild sensory loss to complete paraplegia. Cytokines such as TNF-alpha and IL-6 may play an important part in the pathogenesis of osteoporosis in early AS, and IL-6 levels have been correlated with markers of disease activity and severity. In late AS, mechanical factors such as decreased mobility and the support provided by extraspinal bone may play a role in vertebral osteoporosis. Screening patients with AS for the presence of osteoporosis is an important, but contentious subject. This and subsequent monitoring needs to be considered in all patients, but longterm studies are needed to determine with confidence which patients should undergo screening, by which methods, and how often. The treatment of osteoporosis in AS is at present similar to that used for primary osteoporosis, except that due to the male predominance and a relatively young age of patients, there is a limited role for hormone replacement therapy. Exercise regimens and bisphosphonates are widely used, but a study of the relative efficacy of different bisphosphonate agents in patients with AS is required.
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PMID:How should clinicians manage osteoporosis in ankylosing spondylitis? 1213 13

To date, no studies have been published on incident deformities in patients with rheumatoid arthritis (RA). Morphometric X-ray absorptiometry (MXA) is an alternative to conventional X-rays for identifying vertebral deformities. The aim of the present study was to describe the incidence of vertebral deformities in 255 female RA patients measured by MXA, and the relationship between incident deformities and clinical and demographic variables. MXA is still under evaluation for its ability to identify deformities, so we explored four different cut-off thresholds including fixed percentage reduction and the principle of least significant change (LSC). MXA (T4-L4) and BMD (L2-L4 and total hip; Lunar Expert) were performed on 255 patients (mean age 54.3, range 29.2-70.8 years) at baseline and after a mean period of 2.3 years. MXA scans were analyzed pairwise by the same trained technician, and incident deformities calculated applying LSC with a 99.9% and 99.99% confidence limit, and a fixed reduction of 20% and 25% for anterior, middle or posterior heights. Long term precision (%CV) of height measurements for all vertebrae combined (T4-L4) were 4.8, 4.8 and 4.4, respectively. Frequency and distribution of incident deformities varied from 39 deformities in 33 patients (fixed 20% reduction) to 17 deformities in 15 patients (fixed 25% reduction), and quality control analyses revealed a high number of presumed false deformities. Incidence per 100 patient years varied from 2.9 to 6.7 deformities according to method, and was comparable to those obtained from intervention studies in corticosteroid-induced osteoporosis. Patients with incident deformities were significantly older, had lower BMD, higher disability and more often a previous non-vertebral fractures than those without incident deformities Incident deformities by MXA need further evaluation in secondary osteoporosis. It seems, however, that older patients with previous limb fractures and low BMD are especially prone to this complication.
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PMID:Incidence of vertebral deformities in 255 female rheumatoid arthritis patients measured by morphometric X-ray absorptiometry. 1519 38

Risk factors for osteoporosis based on literally analysis were reviewed. For the prevention for the incidence of osteoporosis, the risk factors were low BMI, smoking and low impact exercise. Calcium and Vitamin D intake was the important preventive factor for the disease. Risk factors to assess the prevalent osteoporosis early were also reviewed. Finally, risk assessment for osteoporosis integrated by members of WHO collaborating centre for metabolic bone diseases were stated. They have undertaken a series of meta-analyses to identify clinical risk factors for fracture to determine their dependence upon age and sex. These were based on the individual data from prospective population-based studies. They concluded the risk factors for osteoporosis were age female-sex, low BMI, family history of fracture, current smoking, ever use of systemic corticosteroids, alcohol intake more than two units per day, rheumatoid arthritis and low BMD at the femoral neck or total hip.
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PMID:[Risk factors for osteoporosis in Japan]. 1613 43

The development of secondary osteoporosis in rheumatoid arthritis (RA) has recently become well recognized, characterized by demineralization at axial and in particular periarticular peripheral bone sites. Our aim was to evaluate multisite quantitative ultrasound (QUS) compared to digital X-ray radiogrammetry (DXR) by the quantification of cortical bone loss dependent on the severity of RA. Fifty-three patients with verified RA underwent QUS measurements (Sunlight Omnisense 7000) with estimation of the speed of sound (QUS-SOS) at the distal radius and at the phalanx of the third digit. Also, bone mineral density (DXR-BMD) and metacarpal index (DXR-MCI) were estimated on metacarpals II-IV using DXR technology. Additionally, Larsen score and Steinbroker stage were assessed. Disease activity of RA was estimated by disease activity score 28 (DAS 28). For the group with minor disease activity (3.2 <or= DAS <or= 5.1), QUS-SOS (phalanx) showed a significant association to DXR-BMD (R = 0.66) and DXR-MCI (R = 0.52). In the case of accentuated disease activity (DAS > 5.1), QUS-SOS of the radius revealed a significant correlation to DXR-BMD (R = 0.71) and DXR-MCI (R = 0.84), whereas for QUS-SOS (phalanx) no significant association to the DXR parameters was shown. The DXR parameters and, to a lesser extent, the QUS data also demonstrated pronounced declines in the case of accentuated disease activity (DAS > 5.1). Both DXR-BMD (-25.9 %, P < 0.01) and DXR-MCI (-38.6 %, P < 0.01) revealed a notable reduction dependent on the severity of RA. Otherwise, QUS-SOS marginally decreased, with -2.6% (radius) and -3.9% (phalanx). DXR revealed a significant reduction of DXR-BMD as well as DXR-MCI dependent on the severity of RA and surpassed multisite QUS as a promising diagnostic tool.
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PMID:Peripheral bone status in rheumatoid arthritis evaluated by digital X-ray radiogrammetry and compared with multisite quantitative ultrasound. 1639 36


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