Haugen IK et al. (2007) Bone mineral density in patients with hand osteoarthritis compared to population controls and patients with rheumatoid arthritis. Ann Rheum Dis 66: 1594–1598

A few studies have reported increased BMD in patients with osteoarthritis (OA), but the findings for hand OA (HOA) have been inconclusive. Haugen et al., therefore, compared BMD levels and frequency of osteoporosis at the total hip, femoral neck and lumbar spine in patients with HOA, rheumatoid arthritis (RA) and in controls; furthermore, the relationship between BMD and disease characteristics in patients with HOA was investigated.

The study, conducted in Oslo, Norway, included women (aged 50–70 years) with HOA (n = 190) and RA (n = 194), and population controls (n = 122). Participants' BMD was measured by the same dual-energy X-ray absorptiometry equipment, and self-reported questionnaires, clinical joint examination and interview were used to obtain demographic and clinical variables.

BMD levels (adjusted for height, weight and age) were increased in patients with HOA compared with those in controls or in patients with RA, but BMD levels did not correlate with either symptom duration or health status in patients with HOA. Frequency of osteoporosis was lower in patients with HOA than those with RA, but was not significantly different between patients with HOA and controls. Lastly, adjusted BMD levels were similar for patients with HOA only and those with additional knee OA.

The findings provide evidence that increased BMD precedes the development of OA, although the authors concede that lack of adjustment for confounders such as smoking might have contributed to the increased BMD in the cohort of patients with HOA.