Rmr. Pereira et al., EVALUATION BY DUAL X-RAY ABSORPTIOMETRY (DXA) OF BONE-MINERAL DENSITYIN CHILDREN WITH JUVENILE CHRONIC ARTHRITIS, Clinical and experimental rheumatology, 16(4), 1998, pp. 495-501
Objective To study the relationship between bone mineral loss and dise
ase subtype, disease duration and corticosteroid use in children with
juvenile chronic arthritis (JCA). Methods Bone mineral density (BMD) w
as evaluated by dual X-ray absorptiometry (DXA), using a Hologic QDR 1
000 densitometer. Sixty-two children with JCA and 157 healthy children
, aged 5 - 18 years, were studied. Bone mass was measured in the lumba
r spine at the L1 - L4 level (LS), in the femoral neck (FN) and in the
distal one-tenth radius (DR). Results A decrease in bone mineral dens
ity was observed in 50-60% of the JCA patients in the three regions st
udied. Those patients who had undergone corticosteroid treatment showe
d significant bone loss in the DR and LS (trabecular bone), but not in
the FN (cortical bone). Bone mass loss was seen for all three disease
subtypes, being higher in the patients with polyarticular JCA (partic
ularly in the DR), although this different was not significant. There
was a significant difference in disease duration between the children
with decreased BMD and those with no BMD decrease in the same regions.
Conclusion A decrease in bone mineral density was found in 50 - 60% o
f all the JCA patients in this series, regardless of the disease subty
pe. Corticosteroid use apparently had an effect on the BMD in the trab
ecular bone. The data also show a correlation between the loss of BMD
in both cortical and trabecular bone and a long disease duration.