Clinical news 14/05/2025
Patients with rheumatic diseases, such as Rheumatoid Arthritis (RA) and Spondyloarthritis, are at an increased risk of developing osteoporosis. However, identifying fracture risk in this population presents unique challenges. Most osteoporotic fractures occur in individuals with bone density readings that fall outside the osteoporotic range, complicating early diagnosis and prevention strategies.
Moreover, bone mineral density (BMD) measurements can be misleading in patients with rheumatic diseases. Inflammatory changes, joint damage, and other factors can artificially elevate BMD values, making DEXA scans less reliable as a standalone tool. This is where Trabecular Bone Score (TBS) plays a crucial role.
TBS assesses bone microarchitecture and has proven to be a more accurate predictor of fracture risk in rheumatic disease patients than BMD or even FRAX® scores. Lower TBS values in patients with RA and Spondyloarthritis highlight its potential to guide more effective clinical decisions and treatment plans.
Here are three leading studies showcasing the utility of TBS in rheumatic disease management:
TBS and Muscle Mass in RA
Silva, Felipe F et al. (2024) identified poor bone microarchitecture and low muscle mass as key fracture risk factors in women with long-standing RA.
Read on PubMed
TBS and Homocysteine in RA Patients on Biologics
Ioniță-Radu et al. (2024) explored how TBS correlates with homocysteine levels in RA patients undergoing anti-TNF treatment, offering insight into biochemical markers of bone health.
Read the article on MDPI
TBS and Vertebral Fractures in Axial Spondyloarthritis
Daflaoui et al. (2024) demonstrated a strong link between TBS and vertebral fractures in patients with axial spondyloarthritis, reinforcing its role in routine assessment.
Explore the study on PubMed
Incorporating TBS into fracture risk assessments for patients with rheumatic diseases supports more personalized, effective care.
