Measurement of hand bone mineral content by dual energy x-ray absorptiometry: Development of the method, and its application in normal volunteers and in patients with rheumatoid arthritis

Atulya (Atul) Deodhar, J. Brabyn, P. W. Jones, M. J. Davis, A. D. Woolf

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70 Citations (Scopus)

Abstract

Objectives-To develop a method of measuring hand bone mineral content (BMC) by dual energy x ray absorptiometry (DXA); to apply this method of measuring hand BMC to normal volunteers to ascertain causes of variability; and to measure hand BMC in patients with rheumatoid arthritis (RA) of varying duration and severity. Methods-The x ray beam of the Hologic QDR 1000 dual energy x ray absorptiometer was hardened by introducing a perspex-aluminium plate and the analysis software altered to allow for the small tissue bulk of the hand compared with the torso. Ninety five volunteers (46 men age 24-81 and 49 women age 20-83) had scans of both hands. Eight volunteers were assessed repeatedly to establish reproducibility and effect ofhand position. Fifty six patients (22 men, 34 women, age range 25-86 years) with RA of differing duration and severity, had hand BMC measurement by DXA. Results-The precision of BMC measurement was 23-/3% with no additional variation due to hand position. Hand dominance had no significant effect on BMC. In men, hand BMC correlated with height (r = 0.57, p <0.0001), weight (r = 0.58, p <0.0001), forearm span (r = 0.5, p = 0.0006) and hand volume (r = 0.66, p <0.0001). In women hand BMC correlated with height (r = 0.66, p <0.0001), weight (r = 0 4, p =0.003), forearm span (r = 0.3, p = 0.03) and hand volume (r = 0 49, p = 0.0008). After correcting for all these variables, male volunteers had significantly higher hand BMC than female volunteers (p = 0.01) and patients with RA had lower hand BMC than normal volunteers (total hand BMC in male volunteers 90 9 gms, 950/o CI 86-9-95, in male patients 81-7 gms, 95% CI 73-7-89*6, p <0 004, total hand BMC in female volunteers 62-2 gms 95% CI 59-8-64.5, female patients 52-3 gms, 95% CI 48-1-56-5, p <0.005). In patients with RA, the hand BMC showed an inverse correlation with age (r = -0* 44, p = 0.01), disease duration (r = -0.62, p = 0.0003), Larsen's grades (r = -0.62, p = 0.0002) and modified Sharp's method score (r = -0.69, p <0.0001) in female patients only. Conclusions-A new, sensitive and reproducible technique of measurement of hand bone mineral content by DXA, has been developed and this method has been applied to normal volunteers and patients with RA. Hand dominance had no significant effect on hand BMC. After correcting for physical size, men have higher hand BMC than women. Hand BMC inversely correlates in women patients with disease duration and other validated methods of assessing radiological outcome in RA. Longitudinal studies are needed to establish its role in monitoring disease progression.

Original languageEnglish (US)
Pages (from-to)685-690
Number of pages6
JournalAnnals of the Rheumatic Diseases
Volume53
Issue number10
DOIs
StatePublished - 1994
Externally publishedYes

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Hand Bones
Bone Density
Minerals
Rheumatoid Arthritis
Healthy Volunteers
Bone
X-Rays
X rays
Hand
Volunteers
Forearm
Weights and Measures
Torso

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience
  • Rheumatology
  • Immunology

Cite this

@article{ff4f1e59414a4a35b2f88d4a01b062c6,
title = "Measurement of hand bone mineral content by dual energy x-ray absorptiometry: Development of the method, and its application in normal volunteers and in patients with rheumatoid arthritis",
abstract = "Objectives-To develop a method of measuring hand bone mineral content (BMC) by dual energy x ray absorptiometry (DXA); to apply this method of measuring hand BMC to normal volunteers to ascertain causes of variability; and to measure hand BMC in patients with rheumatoid arthritis (RA) of varying duration and severity. Methods-The x ray beam of the Hologic QDR 1000 dual energy x ray absorptiometer was hardened by introducing a perspex-aluminium plate and the analysis software altered to allow for the small tissue bulk of the hand compared with the torso. Ninety five volunteers (46 men age 24-81 and 49 women age 20-83) had scans of both hands. Eight volunteers were assessed repeatedly to establish reproducibility and effect ofhand position. Fifty six patients (22 men, 34 women, age range 25-86 years) with RA of differing duration and severity, had hand BMC measurement by DXA. Results-The precision of BMC measurement was 23-/3{\%} with no additional variation due to hand position. Hand dominance had no significant effect on BMC. In men, hand BMC correlated with height (r = 0.57, p <0.0001), weight (r = 0.58, p <0.0001), forearm span (r = 0.5, p = 0.0006) and hand volume (r = 0.66, p <0.0001). In women hand BMC correlated with height (r = 0.66, p <0.0001), weight (r = 0 4, p =0.003), forearm span (r = 0.3, p = 0.03) and hand volume (r = 0 49, p = 0.0008). After correcting for all these variables, male volunteers had significantly higher hand BMC than female volunteers (p = 0.01) and patients with RA had lower hand BMC than normal volunteers (total hand BMC in male volunteers 90 9 gms, 950/o CI 86-9-95, in male patients 81-7 gms, 95{\%} CI 73-7-89*6, p <0 004, total hand BMC in female volunteers 62-2 gms 95{\%} CI 59-8-64.5, female patients 52-3 gms, 95{\%} CI 48-1-56-5, p <0.005). In patients with RA, the hand BMC showed an inverse correlation with age (r = -0* 44, p = 0.01), disease duration (r = -0.62, p = 0.0003), Larsen's grades (r = -0.62, p = 0.0002) and modified Sharp's method score (r = -0.69, p <0.0001) in female patients only. Conclusions-A new, sensitive and reproducible technique of measurement of hand bone mineral content by DXA, has been developed and this method has been applied to normal volunteers and patients with RA. Hand dominance had no significant effect on hand BMC. After correcting for physical size, men have higher hand BMC than women. Hand BMC inversely correlates in women patients with disease duration and other validated methods of assessing radiological outcome in RA. Longitudinal studies are needed to establish its role in monitoring disease progression.",
author = "Deodhar, {Atulya (Atul)} and J. Brabyn and Jones, {P. W.} and Davis, {M. J.} and Woolf, {A. D.}",
year = "1994",
doi = "10.1136/ard.53.10.685",
language = "English (US)",
volume = "53",
pages = "685--690",
journal = "Annals of the Rheumatic Diseases",
issn = "0003-4967",
publisher = "BMJ Publishing Group",
number = "10",

}

TY - JOUR

T1 - Measurement of hand bone mineral content by dual energy x-ray absorptiometry

T2 - Development of the method, and its application in normal volunteers and in patients with rheumatoid arthritis

AU - Deodhar, Atulya (Atul)

AU - Brabyn, J.

AU - Jones, P. W.

AU - Davis, M. J.

AU - Woolf, A. D.

PY - 1994

Y1 - 1994

N2 - Objectives-To develop a method of measuring hand bone mineral content (BMC) by dual energy x ray absorptiometry (DXA); to apply this method of measuring hand BMC to normal volunteers to ascertain causes of variability; and to measure hand BMC in patients with rheumatoid arthritis (RA) of varying duration and severity. Methods-The x ray beam of the Hologic QDR 1000 dual energy x ray absorptiometer was hardened by introducing a perspex-aluminium plate and the analysis software altered to allow for the small tissue bulk of the hand compared with the torso. Ninety five volunteers (46 men age 24-81 and 49 women age 20-83) had scans of both hands. Eight volunteers were assessed repeatedly to establish reproducibility and effect ofhand position. Fifty six patients (22 men, 34 women, age range 25-86 years) with RA of differing duration and severity, had hand BMC measurement by DXA. Results-The precision of BMC measurement was 23-/3% with no additional variation due to hand position. Hand dominance had no significant effect on BMC. In men, hand BMC correlated with height (r = 0.57, p <0.0001), weight (r = 0.58, p <0.0001), forearm span (r = 0.5, p = 0.0006) and hand volume (r = 0.66, p <0.0001). In women hand BMC correlated with height (r = 0.66, p <0.0001), weight (r = 0 4, p =0.003), forearm span (r = 0.3, p = 0.03) and hand volume (r = 0 49, p = 0.0008). After correcting for all these variables, male volunteers had significantly higher hand BMC than female volunteers (p = 0.01) and patients with RA had lower hand BMC than normal volunteers (total hand BMC in male volunteers 90 9 gms, 950/o CI 86-9-95, in male patients 81-7 gms, 95% CI 73-7-89*6, p <0 004, total hand BMC in female volunteers 62-2 gms 95% CI 59-8-64.5, female patients 52-3 gms, 95% CI 48-1-56-5, p <0.005). In patients with RA, the hand BMC showed an inverse correlation with age (r = -0* 44, p = 0.01), disease duration (r = -0.62, p = 0.0003), Larsen's grades (r = -0.62, p = 0.0002) and modified Sharp's method score (r = -0.69, p <0.0001) in female patients only. Conclusions-A new, sensitive and reproducible technique of measurement of hand bone mineral content by DXA, has been developed and this method has been applied to normal volunteers and patients with RA. Hand dominance had no significant effect on hand BMC. After correcting for physical size, men have higher hand BMC than women. Hand BMC inversely correlates in women patients with disease duration and other validated methods of assessing radiological outcome in RA. Longitudinal studies are needed to establish its role in monitoring disease progression.

AB - Objectives-To develop a method of measuring hand bone mineral content (BMC) by dual energy x ray absorptiometry (DXA); to apply this method of measuring hand BMC to normal volunteers to ascertain causes of variability; and to measure hand BMC in patients with rheumatoid arthritis (RA) of varying duration and severity. Methods-The x ray beam of the Hologic QDR 1000 dual energy x ray absorptiometer was hardened by introducing a perspex-aluminium plate and the analysis software altered to allow for the small tissue bulk of the hand compared with the torso. Ninety five volunteers (46 men age 24-81 and 49 women age 20-83) had scans of both hands. Eight volunteers were assessed repeatedly to establish reproducibility and effect ofhand position. Fifty six patients (22 men, 34 women, age range 25-86 years) with RA of differing duration and severity, had hand BMC measurement by DXA. Results-The precision of BMC measurement was 23-/3% with no additional variation due to hand position. Hand dominance had no significant effect on BMC. In men, hand BMC correlated with height (r = 0.57, p <0.0001), weight (r = 0.58, p <0.0001), forearm span (r = 0.5, p = 0.0006) and hand volume (r = 0.66, p <0.0001). In women hand BMC correlated with height (r = 0.66, p <0.0001), weight (r = 0 4, p =0.003), forearm span (r = 0.3, p = 0.03) and hand volume (r = 0 49, p = 0.0008). After correcting for all these variables, male volunteers had significantly higher hand BMC than female volunteers (p = 0.01) and patients with RA had lower hand BMC than normal volunteers (total hand BMC in male volunteers 90 9 gms, 950/o CI 86-9-95, in male patients 81-7 gms, 95% CI 73-7-89*6, p <0 004, total hand BMC in female volunteers 62-2 gms 95% CI 59-8-64.5, female patients 52-3 gms, 95% CI 48-1-56-5, p <0.005). In patients with RA, the hand BMC showed an inverse correlation with age (r = -0* 44, p = 0.01), disease duration (r = -0.62, p = 0.0003), Larsen's grades (r = -0.62, p = 0.0002) and modified Sharp's method score (r = -0.69, p <0.0001) in female patients only. Conclusions-A new, sensitive and reproducible technique of measurement of hand bone mineral content by DXA, has been developed and this method has been applied to normal volunteers and patients with RA. Hand dominance had no significant effect on hand BMC. After correcting for physical size, men have higher hand BMC than women. Hand BMC inversely correlates in women patients with disease duration and other validated methods of assessing radiological outcome in RA. Longitudinal studies are needed to establish its role in monitoring disease progression.

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