El-Sherif H E, Kamal R, Moawyah O
Rheumatology and Rehabilitation Department, Faculty of Medicine, Kasr El-Aini Hospital, Cairo University, Cairo, Egypt.
Osteoarthritis Cartilage. 2008 Jan;16(1):12-7. doi: 10.1016/j.joca.2007.05.011. Epub 2007 Jul 26.
The aim of the present study was to assess phalangeal bone mineral density (BMD) in postmenopausal females with hand osteoarthritis (OA) and to correlate the measured levels with the radiographic OA grade, pain, function and disability of the hand.
The study group constituted 40 postmenopausal women with hand OA (range; 45-83 years). Socio-demographic data were collected. They underwent a comprehensive clinical examination of joint status and health outcome measure including Australian Canadian (AUSCAN) OA hand index. Hand radiographs were quantified and graded according to Kellgren and Lawrence (K-L) scoring system. Bone mineral content (BMC) and BMD of the third finger were measured using the accuDEXA (Schick, New York, NY). Twenty females matched for age and years of menopause were studied as a control group.
Phalangeal BMC and BMD were significantly reduced in women with hand OA compared to controls and related to radiological erosive OA. The AUSCAN pain and function subscales were worse in proportion to the severity of hand OA. OA X-ray score was significantly associated with reduced right grip strength, pain, and function scales while, decreased BMD was related to Ritchie index and pain scale.
Postmenopausal women with clinical and radiological hand erosive OA are at risk of development of hand osteoporosis (OP). Phalangeal bone densitometry is an objective reproducible investigation. Poor physical function due to increased pain associated with increasing severity of radiographic hand OA leads to worse BMD results.
本研究旨在评估绝经后手部骨关节炎（OA）女性的指骨骨密度（BMD），并将测量水平与手部OA的放射学分级、疼痛、功能和残疾情况相关联。
研究组由40名绝经后手部OA女性组成（年龄范围45 - 83岁）。收集了社会人口统计学数据。她们接受了包括澳大利亚 - 加拿大（AUSCAN）手部OA指数在内的关节状况和健康结局指标的全面临床检查。手部X线片根据Kellgren和Lawrence（K - L）评分系统进行量化和分级。使用accuDEXA（Schick，纽约州纽约市）测量第三指的骨矿物质含量（BMC）和BMD。选取20名年龄和绝经年限匹配的女性作为对照组进行研究。
与对照组相比，手部OA女性的指骨BMC和BMD显著降低，且与放射学侵蚀性OA相关。AUSCAN疼痛和功能子量表的情况与手部OA的严重程度成比例恶化。OA X线评分与右手握力降低、疼痛和功能量表显著相关，而BMD降低与Ritchie指数和疼痛量表相关。
患有临床和放射学手部侵蚀性OA的绝经后女性有发生手部骨质疏松症（OP）的风险。指骨骨密度测定是一种客观可重复的检查。由于与放射学手部OA严重程度增加相关的疼痛加剧导致身体功能较差，进而导致更差的BMD结果。
