Bone mineral density in children with juvenile chronic arthritis

The aim of this study was to evaluate bone mineral density changes in patie nts with juvenile chronic arthritis (JCA) and to determine the most likely causes of osteoporosis in these patients. Eighteen (11 male, 7 female) pati ents suffering from JCA and 14 healthy controls (10 male, four female) were included in this study. The mean age of the patients and control groups we re 11.0 +/- 3.2 and 10.9 +/- 2.9 years respectively. Disease activity was d etermined by clinical and laboratory evaluation and 'Articular Disease Seve rity Score' (ADSS). Bone mineral density (BMD) of the femoral neck and lumb ar spine was measured by dual photon absorptiometry. BMD of the patients at the lumbar spine was significantly lower than the co ntrol group (p < 0.05). This difference was more marked in patients treated with steroids. Femoral neck BMD was also lower in the patient group but th is difference was not statistically significant. There was a negative con-e lation between ADSS and BMD at the spine. In conclusion, trabecular bone lo ss is characteristic for osteoporosis in JCA. Our results indicate that ste roid treatment and disease severity are important factors in the developmen t of osteoporosis in JCA.