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Egyptian Rheumatology and Rehabilitation
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Prevalence of silent nontraumatic vertebral fracture in rheumatoid arthritis: relation with disease duration, disease activity, corticosteroid, and hip buckling ratio

Egyptian Rheumatology and Rehabilitation volume 41, pages 116–121 (2014)Cite this article

Abstract

Objectives

To detect the prevalence of silent nontraumatic vertebral fractures (VFs) in patients with rheumatoid arthritis (RA) and its relation with disease duration, disease activity, corticosteroid (CS), and hip buckling ratio (BR).

Patients and methods

This cross-sectional study included a total of 150 RA patients. Disease activity was assessed using Disease Activity Score-28 (DAS-28). Dual-energy x-ray absorptiometry (DXA) was used to detect bone mineral density (B MD), VFs by vertebral fracture assessment (VFA), and hip BR by hip structural analysis program.

Results

A total of 17 (11.33%) RA patients had 27 silent VFs. Of the 17 VFs patients, 11 and six patients had single and multiple VFs, respectively. Of the 27 VFs, nine and 18 VFs had mild and moderate degree of VF. VF cases were significantly older in age (P = 0.001), had longer disease duration (P < 0.001), more active DAS-28 (P < 0.001), more cumulative CS dose, decreased spinal BMD (P = 0.02), and increased BR (P = 0.001). There were statistically significant relation between VFs and disease duration, DAS-28 and BR (P < 0.001 for all). VFs were independently associated with increased cumulative CS dose, high disease duration, and increased DAS-28 score (P < 0.001).

Conclusion

VFA-DXA should be performed on all RA patients. VF cases were significantly older in age, had long-standing disease duration, increased disease activity, reduced spinal BMD, increased cumulative CS dose, and increased BR. VFs were significantly related to increased disease duration, increased disease activity score, and increased BR of more than 10.

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Authors and Affiliations

  1. Department of Rheumatology and Rehabilitation, Faculty of Medicine, El-Kasr Al-Ainy Hospital, Cairo University, Al-Saraya Street, Postal Code 11451, Cairo, Egypt

    Mohamed M. El-Wakd

  2. Department of Radiodiagnosis, Faculty of Medicine, Ain Shams University, Cairo, Egypt

    Omar H. Omar & Hala Abou Senna

Authors
  1. Mohamed M. El-Wakd
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  2. Omar H. Omar
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  3. Hala Abou Senna
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Corresponding author

Correspondence to Mohamed M. El-Wakd.

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El-Wakd, M.M., Omar, O.H. & Senna, H.A. Prevalence of silent nontraumatic vertebral fracture in rheumatoid arthritis: relation with disease duration, disease activity, corticosteroid, and hip buckling ratio. Egypt Rheumatol Rehabil 41, 116–121 (2014). https://doi.org/10.4103/1110-161X.140527

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  • DOI: https://doi.org/10.4103/1110-161X.140527

Keywords

  • disease activity
  • osteoporosis
  • rheumatoid arthritis
  • vertebral fracture assessment