THE RELATIONSHIP BETWEEN OSTEOARTHRITIS OF THE HANDS, BONE-MINERAL DENSITY, AND OSTEOPOROTIC FRACTURES IN ELDERLY WOMEN

To study the relationship between osteoarthritis (OA) and osteoporosis (OP), radiographic osteoarthritis lesions of the hands (HOA) were qua ntified in 300 healthy women, aged 75 years or more, as a subgroup of a cohort originally recruited for a multicentre study of risk factors for femoral neck fracture. The HOA combined score (i.e. the sum of the grades of joint-space narrowing, osteophytes. erosions and joint misa lignment), the osteophytosis score and the joint-space narrowing score were calculated on a radiograph of both hands. Bone mineral density ( BMD) was measured using dual-energy X-ray absortiometry (Lunar DPX) at the femoral neck, Ward's triangle and the total body. BMDs of the tot al spine, lumbar spine, and the upper and lower limbs were derived fro m the regional analyses of the total body measurement. Correlations be tween bone mass, HOA scores and other variables were explored by multi ple linear regression and stepwise logistic regression analysis. The H OA combined score was positively correlated with increasing age but no t with body mass index. In the multiple regression analyses the HOA co mbined score positively correlated with BMD at all sites, except the f emoral neck and Ward's triangle; the osteophytosis score correlated wi th BMD at all sites; and no correlation was found between BMD and the joint-space narrowing score. According to stepwise logistic regression and after adjustment of BMD for age, women with an HOA combined score higher than 20 had signficantly higher BMD values at all skeletal sit es. Sixty-nine women (23%) reported a history of osteoporotic fracture ; among them, 20 (6.6%) reported a history of vertebral fracture. The OA score of both subgroups was significantly lower than that of women with no history of fracture. These data suggest that in elderly women the severity of HOA is positively correlated with bone mass and that w omen with a high score of HOA more rarely report a history of osteopor otic fracture.