Objective: Fractal bone analysis (Hmean) is a texture parameter ă reflecting bone microarchitecture. The BMA device (D3ATM Medical ă Systems, Orleans, France) is a high-resolution X-ray device that allows ă assessment of bone texture analysis. We aimed to measure Hmean in ă rheumatoid arthritis patients at the second and third metacarpal bones, ă at baseline and after 1 year of follow-up, and to assess the ă relationship of Hmean and rheumatoid arthritis disease parameters. ă Methods: Patients with rheumatoid arthritis according to ACR criteria ă were included. They were assessed over 1 year, in the context of a ă prospective study conducted in Maastricht. For this substudy, activity ă of the disease was assessed by erythrocyte sedimentation rate, ă C-reactive protein and Disease Activity Score 28 performed at each ă visit. Radiographic bone damage was assessed using hand and feet ă radiographs at baseline and on a 1-year basis. The bone texture ă parameters were evaluated on the second and third metacarpal heads of ă the left hand using BMA device. ă Results: One hundred and sixty-five rheumatoid arthritis patients were ă included in this study. At baseline, Hmean was negatively correlated ă with age [r= 0.22 (13= 0.013)] and erythrocyte sedimentation rate ă [r= 0.16 (13= 0.039)]. No significant correlation was found between ă Hmean and Disease Activity Score, disease activity Visual Analog Scale, ă daily corticosteroid dose and C-reactive protein. There was a ă significant increase in Hmean of second and third metacarpal bones over ă 1 year (1.6% and 1.3%, P< 0.01) except in patients with local second ă and third metacarpal bones erosion. ă Conclusion: The bone texture parameter Hmean is influenced by age, ă inflammation and local erosions in rheumatoid arthritis. (C) 2013 ă Societe francaise de rhumatologie. Published by Elsevier Masson SAS. All ă rights reserved.