{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T07:36:58Z","timestamp":1780472218533,"version":"3.54.1"},"reference-count":37,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2007,2,27]],"date-time":"2007-02-27T00:00:00Z","timestamp":1172534400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatism"],"published-print":{"date-parts":[[2007,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To characterize local bone geometry, density, and strength, using peripheral quantitative computed tomography (pQCT), compared with general bone characteristics as measured using dual x\u2010ray absorptiometry (DXA), and to assess their relationship to disease\u2010related factors in children with juvenile rheumatoid arthritis (JRA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty\u2010eight children ages 4\u201318 years with JRA (17 pauciarticular, 23 polyarticular, 8 systemic) were compared with age\u2010matched healthy controls (n = 266). Measurements included cortical and trabecular bone geometry, density, and strength at the distal and midshaft tibia determined by pQCT, and whole\u2010body, lumbar spine, and femoral neck measurements by DXA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Methotrexate (MTX) was prescribed to 23 of 48 patients (47.9%) and glucocorticoids and MTX were prescribed to 15 of 48 patients (31.3%), with the greatest use in children with systemic JRA. All JRA patients had decreased tibia trabecular bone density, cortical bone size and strength, and muscle mass. Children with systemic JRA had lower femoral neck densities. Systemic JRA was associated with a shorter, less mineralized skeleton, while a narrower, less mineralized skeleton was observed in polyarticular JRA. The tibia diaphysis was narrower with decreased muscle mass, but normal, size\u2010adjusted bone mineral in all subtypes indicated a localized effect of JRA on bone. Patients exposed to glucocorticoids and MTX or to glucocorticoids or MTX alone had greatly reduced trabecular density, cortical bone geometry properties, and bone mineral content, muscle mass, and bone strength.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Children with JRA have decreased skeletal size, muscle mass, trabecular bone density, cortical bone geometry, and strength. Not surprisingly, these bone abnormalities are more pronounced in children with greater disease severity.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.22420","type":"journal-article","created":{"date-parts":[[2007,2,27]],"date-time":"2007-02-27T22:12:02Z","timestamp":1172614322000},"page":"984-994","source":"Crossref","is-referenced-by-count":38,"title":["Musculoskeletal abnormalities of the tibia in juvenile rheumatoid arthritis"],"prefix":"10.1002","volume":"56","author":[{"given":"Elena M. 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Wayne","family":"Askew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurie J.","family":"Moyer\u2010Mileur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2007,2,27]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00002281-200109000-00010"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780390506"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200201000-00008"},{"key":"e_1_2_7_5_2","first-page":"2225","article-title":"Association of low bone mass with vitamin D receptor gene and calcitonin receptor gene polymorphisms in juvenile idiopathic arthritis","volume":"29","author":"Masi L","year":"2002","journal-title":"J Rheumatol"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200003)43:3<531::AID-ANR8>3.0.CO;2-X"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01451301"},{"key":"e_1_2_7_8_2","first-page":"38","article-title":"Effects of rheumatic disease and corticosteroid treatment on calcium metabolism and bone density in children assessed one year after diagnosis, using stable isotopes and dual energy x\u2010ray absorptiometry","volume":"58","author":"Perez MD","year":"2000","journal-title":"J Rheumatol"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199904)42:4<790::AID-ANR24>3.0.CO;2-G"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.11097"},{"key":"e_1_2_7_11_2","first-page":"2450","article-title":"Development of bone mineral density at the lumbar spine and femoral neck in juvenile chronic arthritis: a prospective one year followup study","volume":"25","author":"Kotaniemi A","year":"1998","journal-title":"J Rheumatol"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1790080210"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/30.2.86"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF03349860"},{"key":"e_1_2_7_15_2","first-page":"1305","article-title":"Effect of low dose methotrexate on bone density in women with rheumatoid arthritis: results from a multicenter cross\u2010sectional study","volume":"31","author":"Di Munno O","year":"2004","journal-title":"J Rheumatol"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s001980050189"},{"key":"e_1_2_7_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cccn.2003.11.022"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-003-0298-z"},{"key":"e_1_2_7_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.20128"},{"key":"e_1_2_7_20_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1046458"},{"key":"e_1_2_7_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/8756-3282(95)00438-6"},{"key":"e_1_2_7_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780290216"},{"key":"e_1_2_7_23_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-3016.2001.00317.x"},{"key":"e_1_2_7_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/1054-139X(92)90075-M"},{"key":"e_1_2_7_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8223(95)00086-0"},{"key":"e_1_2_7_26_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a117618"},{"key":"e_1_2_7_27_2","doi-asserted-by":"publisher","DOI":"10.1249\/00005768-199301000-00011"},{"key":"e_1_2_7_28_2","doi-asserted-by":"publisher","DOI":"10.1385\/JCD:4:4:313"},{"key":"e_1_2_7_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0047-6374(02)00194-X"},{"key":"e_1_2_7_30_2","first-page":"73","volume-title":"Clinical densitometry in growing patients","author":"Cratree NJ","year":"2006"},{"key":"e_1_2_7_31_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1998.tb01492.x"},{"key":"e_1_2_7_32_2","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-73-6-1332"},{"key":"e_1_2_7_33_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-004-1744-1"},{"key":"e_1_2_7_34_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11926-004-0086-0"},{"key":"e_1_2_7_35_2","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.5650090717"},{"key":"e_1_2_7_36_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.1999.00866.x"},{"key":"e_1_2_7_37_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.57.7.425"},{"key":"e_1_2_7_38_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780390707"}],"container-title":["Arthritis &amp; 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