Bone mineral density [BMD] and bone turnover in rheumatiod arthritis

Bone mineral density [BMD] that is commonly used as a parameter of bone strength was measured in 25 post menopausal female patients with RA, and its correlation with markers of bone turnover, disease activity and functional capacity were studied. Another 10 healthy female matched for age were chosen as a control group. All the patients were subjected to clinical assessment and laboratory investigations. Bone mineral density was measured by single photon absorptiometry, Bone resorption was assessed by measurement of urinary Deoxy pyridenoline [D-Pyd] cross links with an ELISA. While Bone formation was assessed by measurement of serum osteocalcin by radioimmunassay technique. Results showed a significant decrease in BMD, a significant decrease in serum osteocalcin level and a significant increase in urinary Deoxy pyridenoline in RA patients as compared to healthy controls. The decreased BMD showed a significant correlations with the impairment of functional activity and with increased disease activity. Also the decreased BMD showed a significant correlation with the decreased serum osteocalcin and with the increased urinary Deoxy pyridenoline level. From the previous results we can conclude that, the impairment of functional activity and increased disease activity are the major determinants of BMD. So every effort should be used to keep patients with RA mobile which can counteract the adverse effect on Bone. Also the serum oesteocalin as a marker of bone formation was decreased and urinary Deoxy pyridenoline as a useful measure of bone resorption was increased. So, we suggest that the pathogenesis of osteoporosis in RA may be due to uncoupling of Bone turnover

incidence of crystals deposition in inflammatory osteoarthritis

The present study was done to detect the incidence of Hydroxy apatite [HA] Calcium. Pyrophosphate Dihydrate [CPPD] and monosodium urate [MSU] crystals in synovial fluid of inflammatory Osteoarthritis [OA] by using alizarin red S stain and polarized light microscopy This study included 100 patients, 83 females [83%] and 17 males [17%] and their ages were ranged between 38-65 years with a mean of 45.9-1.3 years. HA was detected in 36% of cases, CPPD was detected in 30% of cases MSU was detected in 5% of cases while 55% of cases had no crystals in their synovial fluid. Also we found that there was coexistence between HA and CPPD crystals in 16 cases of those who had crystals in their synovial fluid [45 patients] and also the difference in the incidence between AH and CPPD crystals was statistically in-significant, while the difference between the incidence of HA and MSU as well as the difference between the incidence CPPD and MSU crystals was statistically significant. We concluded that alizarin red S staining is a rapid simple and sensitive technique helpful in detecting the presence of aptite crystals and that the concordance of HA and CPPD crystals might be of potential clinical and pathogenic significance