Detection of low bone mass using quantitative ultrasound measurements at calcaneus: comparative study of an Indian rheumatoid arthritis cohort

Background: Low bone mass in an Indian population combined with bone loss secondary to rheumatoid arthritis (RA) would predict high prevalence of osteoporosis in Indian patients with RA. We used quantitative ultrasound (QUS) to assess bone mass in RA patients and compared it with healthy controls. Methods: One hundred patients with RA and 284 randomly selected healthy controls underwent QUS measurement at the heel. Achilles ultrasonometer was used to measure stiffness index (SI) values and T-scores. Results: Both groups did not differ significantly in Proportion of female gender and postmenopausal females. Prevalence of low bone mass in both the healthy population and RA patients was high. Both SI and T-scores were lower in RA patients and they were significantly reduced in postmenopausal patients; 31% of patients with I A had osteoporosis as compared to 14% of controls. There was no statistically significant correlation between disease duration and T-scores (r = 0.11, P = 0.26) and disease duration and SI (r = 0.12, P = 0.20). Conclusion: Our study has found that both the healthy population and RA patients had lower bone mass compared to Western studies. Prospective studies are required to establish whether this is associated with fractures and to establish factors responsible for these findings.