Radiographic damage associated with low bone mineral density and vertebral deformities in rheumatoid arthritis: the Oslo-Truro-Amsterdam (OSTRA) collaborative study

Arthritis Rheum. 2003 Apr 15;49(2):209-15. doi: 10.1002/art.10996.


Objective: To examine variables associated with bone mineral density (BMD) and vertebral deformities in women with rheumatoid arthritis (RA) from 3 northwest European countries.

Methods: Female patients were recruited from rheumatology clinics in Oslo, Norway; Truro, UK; and Amsterdam, The Netherlands (150 total, 50 per center, age 50-70 years, disease duration > or = 5 years). Demographic and clinical data were collected and BMD was measured by means of dual energy x-ray absorptiometry. Associations between demographic and clinical measures on the one hand and BMD and vertebral deformities on the other were investigated by single and multiple regression analyses.

Results: Body mass index (BMI), medication use, RA damage measures, and BMD differed significantly between the 3 centers. Overall, Norwegian patients had the lowest BMI, used more corticosteroids and anti-osteoporotic drugs, had lower joint damage measured by Larsen score, and lower BMD at both spine and hip. High age, low BMI, and high cumulative dose of corticosteroids (last 2 years) are related to low BMD. A high Larsen score was associated with low BMD at the hip. Larsen score was the independent determinant of vertebral deformities after correction for center, age, BMI, and BMD.

Conclusion: Data from 3 countries on BMD and vertebral deformities in female patients aged 50-70 years with longstanding RA are presented, demonstrating an association between radiographic RA damage and low BMD and between radiographic RA damage and vertebral deformities.

Publication types

  • Multicenter Study

MeSH terms

  • Absorptiometry, Photon
  • Aged
  • Arthritis, Rheumatoid / diagnostic imaging*
  • Arthritis, Rheumatoid / epidemiology
  • Arthritis, Rheumatoid / pathology
  • Bone Density*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Middle Aged
  • Netherlands / epidemiology
  • Norway / epidemiology
  • Osteoporosis / diagnostic imaging
  • Osteoporosis / epidemiology
  • Osteoporosis / pathology
  • Postmenopause
  • Spine / diagnostic imaging*
  • Spine / pathology
  • United Kingdom / epidemiology