Extra-Articular Manifestations in Rheumatoid Arthritis-Predictors of Nonvertebral Fractures

In rheumatoid arthritis the extra-articular manifestations present a marker of disease severity and are accompanied by increased morbidity and mortality. Objectives: The aim of this paper is to study the relationship between extra-articular manifestations and nonvertebral fractures in patients with rheumatoid arthritis. Methods: The study included 130 menopausal women diagnosed with rheumatoid arthritis. Bone mineral density was measured at lumbar spine and femoral by means of dual X-ray osteodensitometry. Nonvertebral fractures such as femur, humerus, or forearm fractures were diagnosed through questioning the subjects The obtained variables were analyzed by bivariate analysis and logistic regression. Results: The mean age was 62.77±7.51 years old. The medium duration of rheumatoid arthritis was 7.91±7.85 years, the frequency of extra-articular manifestations was 25.38%. The frequency of nonvertebral fractures was 19.23%. The frequency of nonvertebral fractures is statistically significantly higher in patients with rheumatoid arthritis who have extra-articular manifestations (36.36% vs 13.40%, p: 0.008). Conclusions: In the presence of extra-articular manifestations in patients with rheumatoid arthritis, primary prevention measures are required for nonvertebral fractures.