POS0131 10-YEAR PROBABILITY OF A MAJOR OSTEOPOROTIC FRACTURES IN WOMEN WITH OSTEOARTHRITIS OF THE KNEE JOINT

Background:The relationship between osteoporosis and osteoarthritis (OA) is complex and contradictory. Some studies suggest a protective effect of OA in osteoporosis [1-2]. However, other studies show that increased bone mineral density (BMD) in OA not only does not reduce the risk of fractures, but can also increase it [3-4].Objectives:To assess the 10-year probability of osteoporotic fractures using the FRAX calculator in women with OA of the knee joint.Methods:The study included 22 women (average age 63.7±1.01 years) diagnosed with ACP of the knee joint according to the ACR criteria (1991). The Control Group included 24 conditionally healthy women without OA knee joint, with an average age of 63.6±1.37 years.The BMD (g/cm2) and the T-criterion (standard deviation, SD) of the neck of the femur and lumbar spine (LI-LIV) were evaluated by the method of two-power X-ray absorption (DXA) (apparatus «Lunar Prodigy Primo», USA). 10-year probability of major osteoporotic fractures (clinically significant fracture of the spine, distal fracture of the forearm, fracture of the proximal femur, or fracture of the shoulder) and fracture of the proximal thigh with the FRAX calculator (version 3.5 for Russian population).Results:An osteopenic syndrome in the cohort under investigation was found in 42 (91.3%) patients, of whom osteopenia in 24 (52.2%) women and osteoporosis in 18 (39.1%). A normal BMD is registered in 4 (8.7%) patients.In the group of patients with knee joint OA, only 2 (9.1%) of women had a normal BMD, 11 (50.0%) of osteoporosis, and 9 (40.9%). Osteopenic syndrome is generally found in 20 (90,9%) patients.In the control group, osteopenic syndrome has been diagnosed in 22 (91,7%) of whom: osteopenia in 13 (54.2%), osteoporosis in 9 (37.5%) patients. Two (8.3%) women had a normal BMD. There were no statistically significant differences in the structure of the osteopenic syndrome among the studied groups (p=0.961).An analysis of the 10-year probability of major osteoporotic fractures found that women with OA knee joint had the above probability of 12.3±0.91, and in the control group 14.2±1.06 (p=0.085).The 10-year probability of fracture of the proximal femur in women with OA was statistically less significant than in the control group: 1.55 (0.70;1.98) and 2.10 (1.20;2.95), (p=0.031), respectively.Conclusion:The total incidence of the osteopenic syndrome in the cohort under investigation was 91.3% (90.9% in women with OA, 91.7% in the control group). The frequency of registration of osteopenia and osteoporosis in women with OA did not differ statistically significantly from the control group. The probability of major osteoporotic fractures within 10 years was comparable in these groups. The probability of a proximal femur fracture in women with OA was statistically significant, but not clinically significant, compared to the control group.References:[1]Yamamoto Y, Turkiewicz A, Wingstrand H, et al. Fragility Fractures in Patients with Rheumatoid Arthritis and Osteoarthritis Compared with the General Population. J Rheumatol. 2015 Nov;42(11):2055-8.[2]Vala CH, Kärrholm J, Kanis JA, et al. Risk for hip fracture before and after total knee replacement in Sweden. Osteoporos Int. 2020 May;31(5):887-895.[3]Kim BY, Kim HA, Jung JY, et al. Clinical Impact of the Fracture Risk Assessment Tool on the Treatment Decision for Osteoporosis in Patients with Knee Osteoarthritis: A Multicenter Comparative Study of the Fracture Risk Assessment Tool and World Health Organization Criteria. J Clin Med. 2019 Jun 26;8(7):918.[4]Soh SE, Barker AL, Morello RT, et al. Applying the International Classification of Functioning, Disability and Health framework to determine the predictors of falls and fractures in people with osteoarthritis or at high risk of developing osteoarthritis: data from the Osteoarthritis Initiative. BMC Musculoskelet Disord. 2020 Feb 29;21(1):138.Disclosure of Interests:None declared

Download Full-text

POS1108 THE ACCURACY OF OSTEOPOROTIC FRACTURE RISK PREDICTION IN PATIENTS WITH RHEUMATOID ARTHRITIS USING THE PREDICTIVE MODEL DEVELOPED AT V.A. NASONOVA REASEARCH INSTITUTE OF RHEUMATOLOGY (RUSSIA) AND FRACTURE RISK ASSESSMENT TOOL (FRAX)

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.1717 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 834.2-835

Author(s):

P. Kozhevnikova ◽

P. Kovalenko ◽

S. Glukhova ◽

I. Dydykina ◽

A. Lila

Keyword(s):

Risk Assessment ◽

High Risk ◽

Fracture Risk ◽

Predictive Model ◽

Osteoporotic Fracture ◽

Assessment Tool ◽

Osteoporotic Fractures ◽

Fracture Risk Assessment ◽

Risk Assessment Tool ◽

Fracture Risk Assessment Tool

Background:FRAX is a computer-based algorithm that calculates the 10-year probability of a major osteoporotic fracture and the 10-year probability of hip fracture. However, FRAX has several limitations in assessing the risk of fracture in patients with rheumatoid arthritis (RA).In 2013 V.A. Nasonova Reasearch Institute of Rheumatology (Russia) developed a predictive mathematical model for assessing the risk of osteoporotic fractures in RA, which includes 2 main risk factors: cumulative glucocorticoid dose (GC), decrease in BMD in the femoral neck to osteoporosis, and 2 additional factors: for patients under 65 years of age - the presence of ischemic heart disease, and for people over 65 - a history of gastric ulcer or duodenal ulcer.Objectives:To compare accuracy of osteoporotic fracture risk prediction in patients with RA using the predictive model developed at V.A. Nasonova Reasearch Institute of Rheumatology (IR) and FRAX.Methods:This monocentric (single-center) prospective study included 70 patients with RA, aged 40 to 80 years. The follow-up period - 8.0 ± 1.2 years; mean age at the baseline was 55.4±7.8 years old; the mean disease duration at the baseline - 14,7±10,2 years. All patients retrospectively calculated the 10-year probability of fractures and prognostic model developed by the IR.Results:According to the Fracture Risk Assessment Tool, 32 (46%) patients had a low risk of osteoporotic fractures, 38 (54%) had a high risk. According to the predictive model of IR 33 (47%) patients had a low risk of osteoporotic fractures, 37 (53%) had a high risk. During the follow-up period, osteoporotic fractures were occurred in 18 (26%) patients: 14 (78%) of them had a high risk of fractures according to the predictive IR model, and 13 (72%) patients - according to the Fracture Risk Assessment Tool. Positive and negative predictive value of the Fracture Risk Assessment Tool was 34% and 84%, respectively, of the predictive model of IR - 38% and 88%, respectively. Prognosis of the predictive model of IR in 73% cases coincided with assessing the 10-year probability of fracture.Conclusion:The predictive model developed at V.A. Nasonova Reasearch Institute of Rheumatology (Russia) showed a higher sensitivity and specificity in determining the risk of osteoporotic fractures in RA patients vs FRAX algorithm.Disclosure of Interests:None declared.

Download Full-text

Ukrainian FRAX version in the male osteoporosis management

PAIN JOINTS SPINE ◽

10.22141/2224-1507.11.2.2021.236563 ◽

2021 ◽

Vol 11 (2) ◽

pp. 53-61

Author(s):

V.V. Povoroznyuk ◽

H. Johansson ◽

N.V. Grygorieva ◽

J.A. Kanis ◽

А.S. Musiіenko ◽

...

Keyword(s):

Risk Assessment ◽

Risk Factor ◽

Fracture Risk ◽

Osteoporotic Fracture ◽

Assessment Tool ◽

Osteoporotic Fractures ◽

High Fracture ◽

General Group ◽

Major Osteoporotic Fractures ◽

History Of

Background. At present, FRAX is a well-known and widely-used risk assessment tool for major osteoporotic fractures. The Ukrainian version of the FRAX algorithm was presented in 2016; with the “intervention threshold” for additional DXA examination and antiosteoporotic treatment of the Ukrainian women published in 2019. However, the data on its possible uses in men are limited. The purpose of the study was to evaluate the possibilities of using the previously developed criteria of the Ukrainian FRAX algorithm in Ukrainian men. Materials and methods. We examined 653 outpatients aged 40–88 years (mean age (M ± SD) — 60.5 ± 11.8 years). We analyzed the results both in the general group and in the age subgroups; in particular, with an account of low-trauma fractures, included in the FRAX calculation, and compared them with the corresponding indices of the Ukrainian women. Results. The most frequent (26.6 %) risk factor for osteoporotic fractures in the group of Ukrainian men was a history of low-trauma fracture (the corresponding index in women was 51.3 %), its presence being the reason for antiosteoporotic treatment initiating. Following upon the risk of major osteoporotic fractures calculated by FRAX, only 6.7 % of men without previous fractures were found to require additional DXA examination in order to re-evaluate the osteoporotic fracture risk, and none had a high fracture risk. 73 % of men without fractures did not have any risk factor included in the FRAX algorithm. Conclusions. This study showed a greater need for both antiosteoporotic treatment without DXA assessment and additional densitometric examination for the osteoporotic fracture risk assessment for the Ukrainian women rather than men, along with a special attention to the presence of previous fractures in men, and consideration of other risk factors for osteoporosis, even those not included in this FRAX algorithm.

Download Full-text

Increased cortical porosity and reduced cortical thickness of the proximal femur are associated with nonvertebral fracture independent of Fracture Risk Assessment Tool and Garvan estimates in postmenopausal women

PLoS ONE ◽

10.1371/journal.pone.0185363 ◽

2017 ◽

Vol 12 (9) ◽

pp. e0185363 ◽

Cited By ~ 10

Author(s):

Rita Kral ◽

Marit Osima ◽

Tove T. Borgen ◽

Roald Vestgaard ◽

Elin Richardsen ◽

...

Keyword(s):

Risk Assessment ◽

Fracture Risk ◽

Postmenopausal Women ◽

Cortical Thickness ◽

Proximal Femur ◽

Assessment Tool ◽

Nonvertebral Fracture ◽

Risk Assessment Tool ◽

Cortical Porosity ◽

Fracture Risk Assessment Tool

Download Full-text

Validation of FRC, a Fracture Risk Assessment Tool, in a Cohort of Older Men: The Osteoporotic Fractures in Men (MrOS) Study

Journal of Clinical Densitometry ◽

10.1016/j.jocd.2012.01.011 ◽

2012 ◽

Vol 15 (3) ◽

pp. 334-342 ◽

Cited By ~ 10

Author(s):

Bruce Ettinger ◽

Hau Liu ◽

Terri Blackwell ◽

Andrew R. Hoffman ◽

Kristine E. Ensrud ◽

...

Keyword(s):

Risk Assessment ◽

Fracture Risk ◽

Assessment Tool ◽

Osteoporotic Fractures ◽

Older Men ◽

Fracture Risk Assessment ◽

Risk Assessment Tool ◽

Fracture Risk Assessment Tool

Download Full-text

Accuracy of a fracture risk assessment tool in Iranian osteopenic and osteoporotic women

Rheumatology Research ◽

10.22631/rr.2016.40677 ◽

2016 ◽

Vol 1 (1) ◽

pp. 15-19 ◽

Cited By ~ 1

Author(s):

Arman Ahmadzadeh ◽

Tahere Sabaghian ◽

Mina Ebrahimi-Rad ◽

Mohammad Moslemizadeh ◽

Mohammad Mehdi Emam ◽

...

Keyword(s):

Risk Assessment ◽

Fracture Risk ◽

Assessment Tool ◽

Fracture Risk Assessment ◽

Risk Assessment Tool ◽

Fracture Risk Assessment Tool

Download Full-text

The Ten Year Probability of Hip Fracture in Thai Population By WHO Fracture Risk Assessment Tool

Journal of Clinical Densitometry ◽

10.1016/j.jocd.2010.01.038 ◽

2010 ◽

Vol 13 (1) ◽

pp. 119

Author(s):

Thananit Sangkomkamhang ◽

Ussanee Swadpanich Sangkomkamhang ◽

Prasit Hanpinichsak ◽

Somkid Lerdsinudom ◽

Tanawat Vaseenon

Keyword(s):

Risk Assessment ◽

Hip Fracture ◽

Fracture Risk ◽

Assessment Tool ◽

Fracture Risk Assessment ◽

Risk Assessment Tool ◽

Thai Population ◽

Fracture Risk Assessment Tool

Download Full-text

Radiology of Osteoporosis

Canadian Association of Radiologists Journal ◽

10.1016/j.carj.2015.02.002 ◽

2016 ◽

Vol 67 (1) ◽

pp. 28-40 ◽

Cited By ~ 15

Author(s):

Thomas M. Link

Keyword(s):

Computed Tomography ◽

Fracture Risk ◽

New Technologies ◽

Assessment Tool ◽

Quantitative Computed Tomography ◽

Osteoporotic Fractures ◽

Fragility Fractures ◽

Bone Architecture ◽

Mineral Density ◽

Fracture Risk Assessment Tool

The radiologist has a number of roles not only in diagnosing but also in treating osteoporosis. Radiologists diagnose fragility fractures with all imaging modalities, which includes magnetic resonance imaging (MRI) demonstrating radiologically occult insufficiency fractures, but also lateral chest radiographs showing asymptomatic vertebral fractures. In particular MRI fragility fractures may have a nonspecific appearance and the radiologists needs to be familiar with the typical locations and findings, to differentiate these fractures from neoplastic lesions. It should be noted that radiologists do not simply need to diagnose fractures related to osteoporosis but also to diagnose those fractures which are complications of osteoporosis related pharmacotherapy. In addition to using standard radiological techniques radiologists also use dual-energy x-ray absorptiometry (DXA) and quantitative computed tomography (QCT) to quantitatively assess bone mineral density for diagnosing osteoporosis or osteopenia as well as to monitor therapy. DXA measurements of the femoral neck are also used to calculate osteoporotic fracture risk based on the Fracture Risk Assessment Tool (FRAX) score, which is universally available. Some of the new technologies such as high-resolution peripheral computed tomography (HR-pQCT) and MR spectroscopy allow assessment of bone architecture and bone marrow composition to characterize fracture risk. Finally radiologists are also involved in the therapy of osteoporotic fractures by using vertebroplasty, kyphoplasty, and sacroplasty. This review article will focus on standard techniques and new concepts in diagnosing and managing osteoporosis.

Download Full-text