Comparação clínica, laboratorial e densitométrica de pacientes com coxartrose e com fraturas do colo femoral / Clinical, laboratory and densitometric comparison of patients with coxarthrosis and femoral neck fractures

RESUMO Objetivo: comparar dados clínicos, laboratoriais e densitométricos de pacientes com osteoartrose e com fratura do colo femoral. Métodos: estudo transversal de pacientes com fratura do colo femoral e osteoartrose do quadril, submetidos à artroplastia de quadril. Dados clínicos, laboratoriais e densitométricos foram coletados. Resultados: cinquenta e três pacientes foram incluídos, 22 com fraturas do colo femoral e 31 com osteoartrose. Pacientes com fratura do colo do fêmur apresentaram maior idade do que os pacientes com osteoartrose, tendo valores de IMC, densidade mineral óssea e força de preensão palmar (pacientes sarcopênicos) inferiores, estando mais incapacitados neurologicamente e apresentando um pior escore ASA. Entre os vários parâmetros bioquímicos analisados, diferenças estatisticamente significantes foram encontrados no cálcio sérico total, cálcio ionizado, vitamina D, tiroxina livre, eritrócitos, hemoglobina, hematócrito, glóbulos brancos totais, neutrófilos, linfócitos e creatinina entre os dois grupos. Outros hormônios analisados e parâmetros bioquímicos não diferiram significativamente, apesar de mostrarem tendências entre os dois grupos. Conclusão: pacientes com fraturas do colo do fêmur são mais idosos do que pacientes com osteoartrose, apresentam um menor peso e IMC, são mais debilitados, muitos com anemia e massa óssea reduzida, além de terem uma diminuição significativa no cálcio total, cálcio ionizado, vitamina D e creatinina e um aumento significativo na tiroxina livre.

ABSTRACT Objective: to compare clinical, laboratory and densitometric data from patients with osteoarthrosis and femoral neck fractures. Methods: we conducted a cross-sectional study of patients with femoral neck fracture and hip osteoarthrosis submitted to hip arthroplasty. We collected clinical, laboratory and densitometric data. Results: we included 53 patients, 22 with femoral neck fractures and 31 with osteoarthrosis. Patients with femoral neck fractures were older than patients with osteoarthrosis, with lower BMI values, bone mineral density and palmar grip strength (sarcopenic patients), being more neurologically impaired and presenting a worse ASA score. Among the various biochemical parameters analyzed, we found statistically significant differences in total serum calcium, ionized calcium, vitamin D, free thyroxine, erythrocytes, hemoglobin, hematocrit, total white blood cells, neutrophils, lymphocytes and creatinine between the two groups. Other hormones analyzed and biochemical parameters did not differ significantly, although they showed trends between the two groups. Conclusion: patients with femoral neck fractures are older than patients with osteoarthrosis, have a lower weight and BMI, are more debilitated, many with anemia and reduced bone mass, and have a significant decrease in total calcium, ionized calcium, vitamin D and creatinine and a significant increase in free thyroxine.

Predictive factors of radiographic progression in ankylosing spondylitis

BACKGROUND/AIMS: The course of ankylosing spondylitis (AS) is rather variable, and the factors that predict radiographic progression remain largely obscure. In this study, we tried to determine the clinical factors and laboratory measures that are useful in predicting the radiographic progression of patients with AS. METHODS: In 64 consecutive patients with AS, we collected radiographic and laboratory data over 3 years. Radiographic data included images of the sacroiliac (SI) and hip joints and laboratory data included areas under the curve (AUC) of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), alkaline phosphatase (ALP), and hemoglobin (Hb). We investigated associations among changes in radiographic scores, initial clinical manifestations and laboratory measurements. RESULTS: Changes in scores for the SI joint and lumbar spine did not correlate with AUC for ESR, CRP, or ALP. AUC for Hb did not significantly correlate with radiographic progression in any joint. Patients with hip arthritis at the initial visit showed significantly higher radiographic score changes after 3 years in the SI and hip joint compared to those without hip arthritis. Patients who had shoulder arthritis as the initial manifestation had significantly increased AUCs for ESR and CRP compared to those without shoulder arthritis. However, at 3 years, the change of the lumbar spine score was significantly higher in patients without shoulder arthritis. CONCLUSIONS: These results indicate that hip arthritis at presentation is a useful clinical marker for predicting the structural damage to the SI and hip joint, and suggest that initial shoulder arthritis correlates with slower radiographic progression of the lumbar spine.