THE PRIMARY ROLE OF STEROIDS ON THE OSTEOPOROSIS IN JUVENILE RHEUMATOID-ARTHRITIS PATIENTS EVALUATED BY DUAL-ENERGY X-RAY ABSORPTIOMETRY

Osteoporosis, a common clinical feature in children affected with Juve nile Rheumatoid Arthritis (JRA), is generally divided into two forms, a localized juxta-articular osteoporosis of the single joints and a ge neralized reduction of bone mass due to the disease itself, joint invo lvement and steroid treatment. Recently Dual Energy X-ray Absorptiomet ry (DEXA) has been suggested for Bone Mineral Density (BMD) measuremen t. In the present study DEXA has been used to investigate the lumbar s pine BMD in JRA patients as compared to healthy children. Our results showed that BMD is reduced in JRA patients (BMD 0.685 g/cm(2)) when co mpared to healthy children (BMD 0.722 g/cm(2)), and it is significantl y lower in the group of patients treated with steroids (BMD 0.623 g/cm (2)) when compared to those treated with nonsteroidal antiinflammatory drugs (BMD 0.710 g/cm(2)). The analysis of all risk factors of bone l oss indicated that steroids represent the only parameter of significan t negative correlation with BMD.