A. Kotaniemi et al., ESTIMATION OF CENTRAL OSTEOPENIA IN CHILDREN WITH CHRONIC POLYARTHRITIS TREATED WITH GLUCOCORTICOIDS, Pediatrics, 91(6), 1993, pp. 1127-1130
Study objective. To investigate the degree and determinants of osteope
nia in juvenile chronic polyarthritis. Design. Retrospective case-cont
rol study of central bone mineral density. Setting. Rheumatism Foundat
ion Hospital and Kuopio University Hospital, Finland. Subjects. A samp
le of 43 girls aged 7 to 19 with juvenile chronic polyarthritis treate
d with systemic glucocorticoids and a control sample of 44 healthy gir
ls matched for age. Main outcome measures. Bone mineral density and bo
ne size (width) measured by dual-energy x-ray absorptiometry and bone
volumetric density calculated as an approximation of true bone density
at both the lumbar spine and femoral neck. Results. The girls with ju
venile chronic arthritis had reduced bone mineral density, bone size,
and bone volumetric density at both the lumbar spine and femoral neck
(statistically significant findings, P = .022 for the bone size of the
femoral neck and P < .001 for the other parameters). At the spine, th
e mean bone mineral density was 80%, the mean bone size 89%, and the m
ean bone volumetric density 89% of the values in the control group. At
the femoral neck, the values were 78%, 93%, and 83%, respectively. Th
e groups were matched for age, but the girls with arthritis were small
er and lighter. In the juvenile arthritis group, the femoral bone mine
ral density and bone volumetric density and the spinal bone width corr
elated negatively with the mean glucocorticoid dose. Conclusion. Axial
bone mineral density is clearly reduced in severe juvenile polyarthri
tis and is mediated by both decreased bone volumetric density and dimi
nished growth.