Osteoporos Int (2017) 28 (Suppl 1):S127–S636 DOI 10.1007/s00198-017-3950-2 World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (WCO-IOF-ESCEO 2017): Poster Abstracts # International Osteoporosis Foundation and National Osteoporosis Foundation 2017 P101 and the analyte concentrations (r=-0.347, p=0.016, and r=- THE EFFECT OF BONE-SEEKING ELEMENTS PRE- 0.549, p <0.001, for lead and aluminum, respectively). SENT IN BONE ON DUAL-ENERGY X-RAY ABSORP- However, the deviation of BMD observed from clinically rel- TIOMETRY AND QUANTITIVE ULTRASOUND- evant concentration of lead and aluminum, which is under 100 MEASUREMENTS: A PHANTOM STUDY μg/g was within 1% of the coefficient of variation of BMD D. Jang1,E.DaSilva1, J. Tavakkoli1, L. Slatkovska2,A.M. intrinsic to DXA. No statistically significant correlation be- Cheung2,A.Pejovic-Milic1 tween QUI and analyte concentrations was observed for all 1Department of Physics, Ryerson University, Toronto, Canada, three elements. 2Centre of Excellence in Skeletal Health Assessment, Joint Conclusions: The results of this study suggest that, strontium Department of Medical Imaging, University of Toronto, induces artificial elevation of BMD measured by DXA as Toronto, Canada previously documented [2], but it does not influence QUI determinations. The use of QUS in conjunction with DXA Objectives: To use trabecular bone-mimicking phantoms to can potentially aid with BMD monitoring of patients who investigate the effect of bone seeking elements such as stron- are taking strontium or has a history of strontium intake. tium, lead and aluminum on bone mineral density (BMD) as Furthermore, clinically relevant levels of bone lead and alu- determined by dual-energy x-ray absorptiometry (DXA), and minum do not induce detectable deviation in measurements of quantitative ultrasound index (QUI) as derived by quantitative BMD or QUI, making both modalities useful in assessing ultrasound (QUS) systems. patients with elevated bone lead or aluminum levels. Materials and Methods: Seven strontium-substituted trabec- References: ular bone-mimicking phantoms with Sr/(Sr+Ca) mole ratios [1] Rizvi B et al. Medical Physics 2016;43:5817 ranging from 0 to 2% mol/mol were constructed using the [2] Liao J et al. Bone 2010;47:882 method previously developed by our research group [1]. Similarly, four lead-doped and four aluminum-doped phan- toms were constructed with the respective analyte concentra- P102 tions ranging from 50 to 200 μg/g. In addition, a 0 μg/g HIP AND EYE INVOLVEMENT IN ANKYLOSING phantom was constructed for the baseline measurements of SPONDYLITIS lead and aluminum. The volumetric mineral density of all C. Criveanu1,C.F.Palici1,A.E.Musetescu1,A.L. phantoms was kept constant at 200 mg/cm3. The phantoms Barbulescu1, F. A. Vreju1, A. Rosu1,P.L.Ciurea1 were quantified for their BMD and QUI by a Hologic 1University of Medicine and Pharmacy, Craiova, Romania Horizon® DXA device and a Hologic Sahara® QUS device, respectively. Background: Ankylosing spondylitis (AS) is a chronic sys- Results: A strong positive correlation was observed between temic inflammatory disease that primarily affects axial skele- BMDdeterminedbyDXAandmoleratioofstrontium ton, but with an important involvement of peripheral joints (r=0.993 and p <0.001). In the cases of lead and aluminum, and extra-skeleton disorders. Hip involvement in AS is a com- negative correlations were observed between measured BMD mon and disabling condition and in contrast to the classical S128 Osteoporos Int (2017) 28 (Suppl 1):S127–S636 changes of AS in the spine, inflammation in the hip does not in the architecture and overall appearance of the bone. The lead to formation of new bone, but results in an erosive dis- disorder may be monostotic or polyostotic and affect any ease. Acute anterior uveitis is a common manifestation of AS, bone in the body, but never the entire skeleton. PDB is that can occur onset or in the course of the disease, and can classically identified in the skull, thoracolumbar spine, pel- lead to serious visual complications. vis as well as long bones of the lower extremity. Objectives: To evaluate radiological hip abnormalities and to Interactions between environmental and genetic factors establish a correlation with acute anterior uveitis. are considered essential to the development of Paget's dis- Methods: This study group included 36 male patients with ease. Mutations in the codingregionofsequestosome-1 define AS, with 45,5 years mean age (range 23-68) and mean (SQSTM1), which encodes the p62 protein are linked to disease duration of 17,4 years. All patients were assessed for Paget's disease. Chronic measles (MV) infection has been hip involvement by performing an X-ray radiography and suggested the environmental factor induce Paget's disease. ophthalmological exam for anterior uveitis. Typical clinical It is a well-characterized metabolic disorder of bone due to findings included regional pain, muscle atrophy, flexion con- rapid bone remodeling and turnover that results in bony tractures and limitation of motion on hip joint. Anterior uveitis overgrowth at single or multiple skeletal sites and presents is easily to diagnose by red and painful eye, photophobia and as radiographical and biochemical markers alterations. blurred vision. Bisphosphonates are now considered as the standard treat- Results: The radiographic findings was concentric space ment for active Paget’s disease that subsequently normal- narrowing (38,8%), osteophytosis (27,7%), protrusion izes alkaline phosphatase and PTH levels, and pain relief. acetabuli (13,8%), 11,1% was normal and 8,3% had hip an- Material and methods: The nonrandomized retrospective kylosing and needed total hip replacement. Radiographic and study was conducted. Thirty-six patients with diagnosed clinical signs of hip involvement showed significant positive PDB were included in this study. Indications for therapy in- correlation. Coxitis tend to begin early in disease course, av- cluded extensive disease, pagetic deformities, neurologic erage age of hip involvement was 36 years. From the 36 pa- complications, and pagetic pain. Patients were treated with tients, 9 (25%) had one or more acute anterior uveitis episodes long-term pamidronate from 2008 to 2015. The study group in the course of disease. From them, 3 (33,3%) needed total consisted of 17 males and 19 females in average age 60,3 hip replacement, 4 (44,4%) had protrusion acetabuli and the years (men - 60,6 years and women 58,2 years). The average remaining 2 (22,2%) had a normal hip joint. follow-up was 4,27 years. Alkaline phosphatase, PHT, Conclusions: Patients with early AS onset had higher fre- Calcium, Phosphorus, and 25OH D3 were tested. The therapy quencies of hip involvement and also had a greater need for was administered when alkaline phosphatase or PTH increase total hip replacement, as compared with patients with adult- or when pain deteriorated. The pamidronate was administered onset AS. We consider that hip involvement in AS patients intravenously at a dose 1 mg/kg of body mass. Vitamin D was should be assessed routinely in both young and adult AS pa- supplemented if required. tients. The study demonstrates an association between coxitis Results: The mean serum alkaline phosphatase level was and anterior unilateral and recurrent uveitis. Uveitis and 259,77 U/L (maximum 2606) before therapy and 152,19 coxitis require simultaneous rheumatology and ophthalmolo- U/L after treatment, a decrease of 58,58% (P<0.01). gy approach, being associated with unfavorable evolution of Calcium and Phosphorus levels were within the norm range AS. (Ca 8,87 mg/dL; Ph 3,31 mg/dL) but 25 OH D3 was usually low 24,4 j.m. (3,8-52). Laboratory findings usually normal- ized after pamidronate administration. Local orthopedic defor- P103 mities due to PDB (hip osteoarthritis 3 cases, tibial deformities LONG-TERM EFFECTS OF INTRAVENOUS PAMIDRO- in 2 cases), spinal stenosis 2 cases required conservative or NATE IN PAGET'S DISEASE OF BONE surgical treatment. Pamidronate was well tolerated. A "flu- W. Glinkowski1, J. Janowicz1,T.Rudnicki2 like" syndrome after the infusion was infrequently reported. 1Medical university of Warsaw, Warszawa, Poland, 2Baby Patients reported significant pain relief after pamidronate Jesus Clinical Hospital, Warszawa, Poland administration. Conclusions: PDB in Poland is relatively rare. This disorder Objective: To evaluate the effect of intravenously adminis- is frequently referred to orthopedic department specialized in tered pamidronate in patients with Paget's disease of bone. metabolic bone diseases due to laboratory findings or ortho- Background: Paget’s disease of bone (PDB), also known pedic deformity. The intravenous administration of as osteitis deformans since 1877. PDB has been regarded pamidronate in a dose of 1 mg/kg of the body mass in patients as the second most frequent metabolic bone disorder in with Paget's disease of bone, was efficient in remissions of many publications. The prevalence of PDB in Poland is symptoms like pagetic pain and decrease of serum alkaline low. This bone remodeling disorder is leading to changes phosphatase level. Osteoporos Int (2017) 28 (Suppl 1):S127–S636 S129 P104 patients with vertebral haemangioma presenting with myelop- EPIDEMIOLOGY OF VITAMIN D SUPPLY IN GER- athy treated surgically. MANY: ASSESSMENT ON 1343 UNSELECTED Materials and method: Six patients (Mean age 14.17 years, PATIENTS range: 12- 17 years, 3 females and 3 males) treated by J. D. Ringe1,P.Farahmand1
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