La radiografía de osteoartritis asociada con diferentes tasas de pérdida de hueso comparada con radiografías de rodilla normal.
Men and women with radiographic osteoarthritis (OA) of the hands and knees have different rates of bone loss than those with normal knee radiographs, reports a study from the United States. Although studies have reported higher adjusted levels of bone mineral density (BMD) in patients with radiographic OA, there is little longitudinal data on the rates of BMD changes in persons with radiographic OA. Using data from the Baltimore Longitudinal Study of Aging, Marc Hochberg, MD, PhD, and colleagues, Maryland Veterans Affairs Health Care System and the Gerontology Research Center, Baltimore, examined radiographs of the hands and knees of 298 Caucasian men and 139 Caucasian women, aged 20 or older, who also had 2 or more BMD measurements taken at least 4 years apart to determine if the rates of bone loss in patients with radiographic evidence of OA differed from persons with normal radiographs. In a subgroup of 179 Caucasian men and 110 Caucasian women, aged 20 and above, who had 1 or both knees free of osteoarthritis as determined by baseline bilateral radiographs of the knees taken on average 10 years apart, and in whom baseline measurements of BMD were available of lumbar spine and/or femoral neck, the authors examined whether people with normal knee radiographs with higher adjusted BMD levels were at increased risk of developing radiographic OA. In both men and women with radiographic OA, the adjusted rate of bone loss at the distal radius was significantly greater than 0 (P < .01) but no difference was found in those without hand osteoarthritis. A significantly different rate from 0 of the rate of bone loss at the distal radius (P < .01) was also found in men and women without knee OA, but not in those with knee OA. Women, but not men, with radiographic hand OA had significantly greater adjusted rate of bone loss than women without hand OA. After adjusting for age, gender, and body mass index, an increased risk of developing incident radiographic knee OA was associated with higher BMD at the lumbar spine, but not at the femoral neck. These data show that rates of bone loss differ in patients with radiographic OA compared to people with normal radiographs and that this difference varies between the site of OA and that of BMD measurement. With the caveat that further data are needed to investigate the association between BMD changes and radiographic progression of OA, the authors conclude that these data "further support a role for higher bone mass in the development of radiographic knee OA."
Osteoarthritis Cartilage 2004;12:S:45-48.