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Subject Area

Physical Medicine, Rheumatology and Rehabilitation

Article Type

Original Study

Abstract

Objectives To measure bone mineral density (BMD) in patients with juvenile idiopathic arthritis (JIA) and to relate it to disease activity. Background Low BMD is a common finding in children with JIA. It is associated with a high risk of osteopenia and osteoporosis, which increases the risk of fracture. Dual-energy radiograph absorptiometry (DEXA) of the lumbar spine using the Z score is used for measurement of BMD in pediatrics. Patients and methods The study included 50 patients diagnosed and assessed clinically as JIA (20 females and 30 males). The patients were diagnosed as having JIA according to the criteria of classification of the International League of Associations for Rheumatology. BMD was measured in the lumbar spine using the Z score. The results were correlated with juvenile arthritis disease duration, disease activity, and serum level of bone turnover markers, vitamin D3, parathyroid hormone, calcium, phosphorus, and magnesium. Clinical disease activity was evaluated by juvenile arthritis disease activity score 27. Results The study showed that 36% of patients had low BMD (Z score of <−2) by DEXA of lumbar spine, 64% of patients had normal BMD (Z score >−2), and no patient was given a diagnosis of osteoporosis (BMD Z score ≤−2 and a significant fracture history). There was a significant negative correlation between BMD (DEXA Z score) and juvenile arthritis disease activity score 27, bone turnover markers, and duration of JIA. Conclusion Osteoporosis and osteopenia are common in patients with JIA. BMD decreases among patients with JIA with high disease activity.

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