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Mean progression of total Sharp-van der Heijde (SHS) in hands and feet after up to four years in patients with (black columns) and without (white columns) hand bone mineral density (BMD) loss in the first year of rheumatoid arthritis. The differences in mean total SHS progression after one, two, three and four years between patients with and without hand BMD loss in the first year are all significant (P < 0.05 derived by non-parametric tests).
